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Abstract Venus, lacking an intrinsic global dipole magnetic field, serves as a textbook example of an induced magnetosphere, formed by interplanetary magnetic fields (IMF) enveloping the planet. Yet, various aspects of its magnetospheric dynamics and planetary ion outflows are complex and not well understood. Here we analyze plasma and magnetic field data acquired during the fourth Venus flyby of the Parker Solar Probe (PSP) mission and show evidence for closed topology in the nightside and downstream portion of the Venus magnetosphere (i.e., the magnetotail). The formation of the closed topology involves magnetic reconnection—a process rarely observed at non-magnetized planets. In addition, our study provides an evidence linking the cold Venusian ion flow in the magnetotail directly to magnetic connectivity to the ionosphere, akin to observations at Mars. These findings not only help the understanding of the complex ion flow patterns at Venus but also suggest that magnetic topology is one piece of key information for resolving ion escape mechanisms and thus the atmospheric evolution across various planetary environments and exoplanets.

Abstract Introduction HPTN 083 demonstrated the superiority of long‐acting cabotegravir (CAB‐LA) versus daily oral emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as pre‐exposure prophylaxis (PrEP) among cisgender men and transgender women who have sex with men (MSM/TGW). HPTN 083 provided the first opportunity to understand experiences with injectable PrEP in a clinical trial. Methods Participants from two US sites (Chicago, IL and Atlanta, GA) and one international site (Rio de Janeiro, Brazil) were purposively sampled for individual qualitative interviews (N = 40), between November 2019 and March 2020, to explore trial experiences, barriers to adherence and other factors that may have impacted study implementation or outcomes. The blinded phase ended early due to efficacy; this analysis includes interviews conducted prior to unblinding with three groups defined by adherence (i.e. injection visit attendance): adherent (n = 27), non‐adherent (n = 12) and early discontinuers (n = 1). Data were organized using NVivo software and analysed using content analysis. Results Participants (mean age: 27) were primarily cisgender MSM (90%) and Black/African American (60%). Reasons for trial enrolment and PrEP use included a preference for using HIV prevention medication versus treatment in the event of HIV acquisition; the ability to enhance health via study‐related education and services; access to a novel, convenient HIV prevention product at no cost; and contributing to MSM/TGW communities through research. Participants contrasted positive experiences with study staff with their routine clinical care, and emphasized increased scheduling flexibility, thorough communication, non‐judgemental counselling and open, affirming environments (e.g. compassion, less stigma) as adherence facilitators. Injection experiences were positive overall; some described early injection‐related anxiety, which abated with time and when given some measure of control (e.g. pre‐injection countdown), and minimal injection site discomfort. Some concerns and misperceptions about injectable PrEP were reported. Barriers to adherence, across all adherence categories, included structural factors (e.g. financial constraints, travel) and competing demands (e.g. work schedules). Conclusions Respondents viewed injectable PrEP trial participation as a positive experience and a means of enhancing wellbeing. Study site flexibility and affirming clinic environments, inclusive of non‐judgemental counselling, were key facilitators of adherence. To support injection persistence, interventions that address structural barriers and promote flexible means of injection delivery may be most effective.

Abstract Heavy cold ions at Mars are gravitationally bound to the planet unless some process provides energy to them. Observations show that cold (1 cm−3) O+/O2+ ions with bulk velocities equal to energies ∼1 keV can reach deep into the nightside Martian magnetosheath. These ions are co‐located with a change of the sign of the sunward component of the magnetic field. This magnetic field topology implies the persistence of a localized planetary ions escape channel associated with draped magnetic field lines that are convecting tailward. The observed ion populations propagate approximately in the same direction as surrounding magnetosheath flow and are likely to be almost unheated ionospheric ions from low altitudes. The paper discusses planetary ion energization via Hall electric field originated from ions and electron separation associated with magnetic field curvature.

In this work we analyze plasma and magnetic field data provided by the Parker Solar Probe and Solar Orbiter missions to investigate the radial evolution of the heating of Alfvénic slow wind by imbalanced Alfvén-wave (AW) turbulent fluctuations from 0.06 to 1 au. in our analysis we focus on slow solar-wind intervals with highly imbalanced and incompressible turbulence (i.e., magnetic compressibility C _B = δ B / B ≤ 0.25, plasma compressibility C _n = δ n / n ≤ 0.25, and normalized cross helicity σ _c ≥ 0.65). First, we estimate the AW turbulent dissipation rate from the wave energy equation and find that the radial profile trend is similar to the proton heating rate. Second, we find that the scaling of the empirical AW turbulent dissipation rate Q _W obtained from the wave energy equation matches the scaling from the phenomenological AW turbulent dissipation rate Q _CH09 (with Q _CH09 ≃ 1.55 Q _W ) derived by Chandran & Hollweg based on the model of reflection-driven turbulence. Our results suggest that, as in the fast solar wind, AW turbulence plays a major role in the ion heating that occurs in incompressible slow-wind streams.

BackgroundPeople with a low socioeconomic position (SEP) are less likely to benefit from eHealth interventions, exacerbating social health inequalities. Professionals developing eHealth interventions for this group face numerous challenges. A comprehensive guide to support these professionals in their work could mitigate these inequalities. ObjectiveWe aimed to develop a web-based guide to support professionals in the development, adaptation, evaluation, and implementation of eHealth interventions for people with a low SEP. MethodsThis study consisted of 2 phases. The first phase involved a secondary analysis of 2 previous qualitative and quantitative studies. In this phase, we synthesized insights from the previous studies to develop the guide’s content and information structure. In the second phase, we used a participatory design process. This process included iterative development and evaluation of the guide’s design with 11 professionals who had experience with both eHealth and the target group. We used test versions (prototypes) and think-aloud testing combined with semistructured interviews and a questionnaire to identify design requirements and develop and adapt the guide accordingly. ResultsThe secondary analysis resulted in a framework of recommendations for developing the guide, which was categorized under 5 themes: development, reach, adherence, evaluation, and implementation. The participatory design process resulted in 16 requirements on system, content, and service aspects for the design of the guide. For the system category, the guide was required to have an open navigation strategy leading to more specific information and short pages with visual elements. Content requirements included providing comprehensible information, scientific evidence, a user perspective, information on practical applications, and a personal and informal tone of voice. Service requirements involved improving suitability for different professionals, ensuring long-term viability, and a focus on implementation. Based on these requirements, we developed the final version of “the inclusive eHealth guide.” ConclusionsThe inclusive eHealth guide provides a practical, user-centric tool for professionals aiming to develop, adapt, evaluate, and implement eHealth interventions for people with a low SEP, with the aim of reducing health disparities in this population. Future research should investigate its suitability for different end-user goals, its external validity, its applicability in specific contexts, and its real-world impact on social health inequality.

Women with HIV (WWH) may be more vulnerable to cognitive impairment than men with HIV (MWH), which may be explained by the direct effects of HIV or by sociodemographic and psychiatric characteristics. We recruited 105 people with HIV (PWH; 76 women) with incomplete antiretroviral therapy adherence, comorbid major depressive disorder, and socioeconomically disadvantaged backgrounds. Participants completed neuropsychological testing and measures gathering sociodemographic, medical, and psychiatric information. We compared WWH and MWH cognitive performance using unadjusted and adjusted regressions, and within each respective group, we explored predictors of cognitive performance. Results showed no significant between-sex differences in cognitive performance, both globally and within domains. Fewer years of education ( β = 0.94), illiteracy ( β = 4.55), and greater food insecurity ( β = −0.28) predicted lower cognitive performance in WWH but not MWH. We conclude that sex differences in PWH are likely due to sample characteristics representing broader inequalities, rather than true biological differences.

Abstract Background Tuberculosis (TB) represents a significant public health threat in India. Adherence to antitubercular therapy (ATT) is the key to reducing the burden of this infectious disease. Suboptimal adherence to ATT and lack of demonstrated feasibility of current strategies for monitoring ATT adherence highlights the need for alternative adherence monitoring systems. Methods A quantitative survey was conducted to assess the acceptance of and willingness to use a digital pill system (DPS) as a tool for monitoring ATT adherence among stakeholders directly involved in the management of patients with TB in India. Participants reviewed a video explaining the DPS and completed a survey, which covered sociodemographics, degree of involvement with TB patients, initial impressions of the DPS, and perceived challenges for deploying the technology in India. Participants were also asked to interpret mock DPS adherence data. Results The mean age was 34.3 (SD = 7.3), and participants (N = 50) were predominantly male (70%). The sample comprised internists (52%) and pulmonologists (30%), with a median of 4 years’ experience (IQR 3, 6) in the management of TB patients. No participants had previously used a DPS, but some reported prior awareness of the technology (22%). Most reported that they would recommend use of a DPS to patients on ATT (76%), and that they would use a DPS in both the intensive and continuation phases of TB management (64%). The majority viewed the DPS (82%) as a useful alternative to directly observed therapy-short course (DOTS), particularly given the ongoing COVID-19 pandemic. Participants reported that a DPS would be most effective in patients at risk of nonadherence (64%), as well as those with past nonadherence (64%). Perceived barriers to DPS implementation included lack of patient willingness (92%), cost (86%), and infrastructure constraints (66%). The majority of participants were able to accurately interpret patterns of adherence (80%), suboptimal adherence (90%), and frank nonadherence (82%) when provided with mock DPS data. Conclusions DPS are viewed as an acceptable, feasible, and useful technology for monitoring ATT adherence by stakeholders directly involved in TB management. Future investigations should explore patient acceptance of DPS and pilot demonstration of the system in the TB context.

Abstract The Martian bow shock stands as the first defense against the solar wind and shapes the Martian magnetosphere. Previous studies showed the correlation between the Martian bow shock location and solar wind parameters. Here we present direct evidence of solar wind effects on the Martian bow shock by analyzing Tianwen‐1 and MAVEN data. We examined three cases where Tianwen‐1 data show rapid oscillations of the bow shock, while MAVEN data record changes in solar wind plasma and magnetic field. The results indicate that the bow shock is rapidly compressed and then expanded during the dynamic pressure pulse in the solar wind, and is also oscillated during the IMF rotation. The superposition of variations in multiple solar wind parameters leads to more intensive bow shock oscillation. This study emphasizes the importance of joint observations by Tianwen‐1 and MAVEN for studying the real‐time response of the Martian magnetosphere to the solar wind.

In order to quantitatively investigate the mechanism of how magnetospheric convection is driven in the region of magnetotail lobes on a global scale, we analyzed data from the ARTEMIS spacecraft in the deep tail and data from the Cluster spacecraft in the near and mid-tail regions. Our previous work revealed that, in the lobes near the Moon’s orbit, the convection can be estimated by using ARTEMIS measurements of lunar ions’ velocity. Based on that, in this paper, we applied machine learning models to these measurements to determine which upstream solar wind parameters significantly drive the lobe convection in magnetotail regions, to help us understand the mechanism that controls the dynamics of the tail lobes. The results demonstrate that the correlations between the predicted and measured convection velocities for the machine learning models (>0.75) are superior to those of the multiple linear regression model (∼0.23–0.43) in the testing dataset. The systematic analysis shows that the IMF and magnetospheric activity play an important role in influencing plasma convection in the global magnetotail lobes.

A unique event known as the disappearing solar wind (DSW), characterized by an extremely low-density solar wind stream, occurred at Mars on 2022 December 26–27. As this stream flowed past Mars, several properties of the Mars–solar wind interaction changed in response to the density drop. We utilize in situ plasma measurements from the Mars Atmosphere and Volatile EvolutioN spacecraft to examine heavy ion escape during this event. We find that escaping ions with energies above and below 30 eV responded differently to the reduction in solar wind density. High-energy ions experienced a decrease in flux, whereas low-energy ions experienced an increase, regardless of whether they were escaping through the plume or tailward channel. Furthermore, we observe a net reduction in the flux of plume escaping ions during the DSW period, primarily due to a considerable reduction in the high-energy component, which typically dominates plume escape. In contrast, the overall flux of tailward escaping ions increased during this period. These variations in heavy ion escape are mainly attributed to substantial reductions in solar wind dynamic pressure and momentum density. This paper provides new insights into the dynamics of heavy ion escape under an exceptional state of the Mars–solar wind interaction.

Since Parker Solar Probe’s (Parker’s) first perihelion pass at the Sun, large-amplitude Alfvén waves grouped in patches have been observed near the Sun throughout the mission. Several formation processes for these magnetic switchback patches have been suggested with no definitive consensus. To provide insight into their formation, we examine the heavy ion properties of several adjacent magnetic switchback patches around Parker’s 11th perihelion pass, capitalizing on a spacecraft lineup with Solar Orbiter where each samples the same solar wind streams over a large range of longitudes. Heavy ion properties (Fe/O, C ^6+ /C ^5+ , O ^7+ /O ^6+ ) related to the wind’s coronal origin, measured with Solar Orbiter, can be linked to switchback patch structures identified near the Sun with Parker. We find that switchback patches do not contain distinctive ion and elemental compositional signatures different from the surrounding nonswitchback solar wind. Both the patches and ambient wind exhibit a range of fast and slow wind qualities, indicating coronal sources with open and closed field lines in close proximity. These observations and modeling indicate switchback patches form in coronal hole boundary wind and with a range of source region magnetic and thermal properties. Furthermore, the heavy ion signatures suggest interchange reconnection and/or shear-driven processes may play a role in their creation.

Solar wind turbulence is a dynamical phenomenon that evolves with heliocentric distance. Orbiting Mars since 2014 September, Mars Atmosphere and Volatile EvolutioN offers a unique opportunity to explore some of its main properties beyond ∼1.38 au. Here, we analyze solar wind turbulence upstream of Mars' bow shock, utilizing more than 5 years of magnetic field and plasma measurements. This analysis is based on two complementary methodologies: (1) the computation of magnetohydrodynamic (MHD) invariants characterizing incompressible fluctuations; (2) the estimation of the incompressible energy cascade rate at MHD scales (i.e., 〈 ε ^T 〉 _MHD ). Our results show the solar wind incompressible fluctuations are primarily in a magnetically dominated regime, with the component traveling away from the Sun having a higher median pseudoenergy. Moreover, turbulent fluctuations have a total energy per mass of up to ∼ 300 km ^2 s ^−2 , a range smaller than reported at 1 au. For these conditions, we determine the probability distribution function of 〈 ε ^T 〉 _MHD ranges mainly between ∼ −1 × 10 ^−16 and ∼1 × 10 ^−16 J m ^−3 s ^−1 , with a median equal to −1.8 × 10 ^−18 J m ^−3 s ^−1 , suggesting back transfer of energy. Our results also suggest that ∣〈 ε ^T 〉 _MHD ∣ is correlated with the total energy per mass of fluctuations and that the median of 〈 ε ^T 〉 _MHD does not vary significantly with the cross-helicity. We find, however, that the medians of the inward and outward pseudoenergy cascade rates vary with the solar wind cross-helicity. Finally, we discuss these results and their implications for future studies that can provide further insight into the factors affecting the solar wind energy transfer rate.

The Moon is enveloped in an exosphere, which is comprised of a variety of neutral atoms and molecules. Once exospheric neutrals are ionized by photons, protons, or electrons from the Sun, the resulting ions are accelerated by the electromagnetic fields of their surroundings and can thereby travel away from their source locations. These ions are the so-called pickup ions and are frequently observed by the two Acceleration, Reconnection, Turbulence, and Electrodynamics of Moon’s Interaction with the Sun (ARTEMIS) spacecraft. In this study, we identify 115 events from an 11 yr period of ARTEMIS observations, which contain a total of 11,987 samples for our statistics. By using analytical ion trajectory calculations, we trace the source location of each pickup ion observation. Most pickup ion trajectories originate near the subsolar point, consistent with the efficiency of sputtering. We find that the flux of pickup ions strongly anticorrelates with the source altitude, providing indirect evidence of decreasing exospheric ion flux with increasing altitude. We also find that the flux of pickup ions does not show a significant relationship with the crustal magnetic field intensity. This implies that a depression of sputtering efficiency or the trapping of near-surface freshly born ions by a crustal magnetic anomaly may not reduce the subsequent pickup ion flux as effectively as expected. In summary, the present paper provides a statistical view of lunar pickup ion fluxes in association with the altitude, local time, and local crustal magnetic field of their source locations.

Abstract Objective: In 2020, we developed a public health decision‐support model for mitigating the spread of SARS‐CoV‐2 infections in Australia and New Zealand. Having demonstrated its capacity to describe disease progression patterns during both countries’ first waves of infections, we describe its utilisation in Victoria in underpinning the State Government's then ‘RoadMap to Reopening’. Methods: Key aspects of population demographics, disease, spatial and behavioural dynamics, as well as the mechanism, timing, and effect of non‐pharmaceutical public health policies responses on the transmission of SARS‐CoV‐2 in both countries were represented in an agent‐based model. We considered scenarios related to the imposition and removal of non‐pharmaceutical interventions on the estimated progression of SARS‐CoV‐2 infections. Results: Wave 1 results suggested elimination of community transmission of SARS‐CoV‐2 was possible in both countries given sustained public adherence to social restrictions beyond 60 days’ duration. However, under scenarios of decaying adherence to restrictions, a second wave of infections (Wave 2) was predicted in Australia. In Victoria's second wave, we estimated in early September 2020 that a rolling 14‐day average of

BackgroundCurrent eHealth interventions are poorly adopted by people with low health literacy (LHL) as they often fail to meet their needs, skills, and preferences. A major reason for this poor adoption is the generic, one-size-fits-all approach taken by designers of these interventions, without addressing the needs, skills, and preferences of disadvantaged groups. Participatory design approaches are effective for developing interventions that fit the needs of specific target groups; yet, very little is known about the practical implications of executing a participatory design project for and with people with LHL. ObjectiveThis study aimed to demonstrate the application of participatory design activities specifically selected to fit the needs and skills of people with LHL and how these were manifested within an overarching eHealth design process. In addition, the study aims to present reflections and implications of these activities that could support future designers to engage people with LHL in their design processes. MethodsWe used the design process of a smart asthma inhaler for people with asthma and LHL to demonstrate participatory design activities. The study was framed under 5 stages of design thinking: empathize, define, ideate, prototype, and test within 2 major iteration cycles. We integrated 3 participatory design activities deemed specifically appropriate for people with LHL: co-constructing stories, experience prototype exhibition, and video prototype evaluation. ResultsCo-constructing stories was found to deepen the understanding of the participant’s motivation to use or not to use maintenance medication. This understanding informed and facilitated the subsequent development of diverse preliminary prototypes of possible interventions. Discussing these prototypes in the experience prototype exhibition helped provoke reactions, thoughts, and feelings about the interventions, and potential scenarios of use. Through the video prototype evaluation, we were able to clearly communicate the goal and functionality of the final version of our intervention and gather appropriate responses from our participants. ConclusionsThis study demonstrates a participatory design approach for and with patients with asthma and LHL. We demonstrated that careful consideration and selection of activities can result in participants that are engaged and feel understood. This paper provides insight into the practical implications of participatory activities with people with LHL and supports and inspires future designers to engage with this disadvantaged target group.

Objectives This quantitative survey sought to understand, among men who have sex with men (MSM) with potentially problematic substance use, the attitudes towards participation in research involving digital pill systems (DPS) for HIV pre-exposure prophylaxis (PrEP) adherence measurement, and the barriers and facilitators to research participation.Design One-time, cross-sectional, online sampling-based survey.Setting US social networking app predominantly focused on MSM.Participants MSM without HIV who reported current use of oral PrEP, potentially problematic substance use and sexual activity in the past 3 months. A total of 157 participants were eligible, passed validity checks and enrolled.Outcome measures Perceptions of DPS usefulness, accuracy and usability (System Usability Scale (SUS)); willingness and motivations to participate in DPS research; preferences for access to and feedback on DPS adherence data; data sharing considerations; and medical mistrust (Group-Based Medical Mistrust Scale (GBMMS)).Results Most of the sample (N=157) was white (n=119, 75.8%), gay (n=124, 79.0%) and cisgender (n=150, 95.5%). The median age was 33 years (IQR: 14). The mean GBMMS score was 13.5 (SD=5.2), and the median SUS score was 70 (IQR: 27.5). In the past 3 months, 36.3% (n=57) reported frequent use of substances before or during sex, and 62.4% (n=98) engaged in condomless sex. While most were adherent to PrEP, approximately 34.4% (n=54) expressed significant worry about daily adherence. Participants wished to monitor their PrEP adherence daily (n=66, 42.0%) and 52% (n=82) were very willing to participate in DPS-based research. The majority were minimally concerned about sharing DPS-detected adherence data with research teams (n=126, 80.3%), and were extremely willing to share these data with healthcare providers (n=109, 69.4%).Conclusions In this sample, MSM without HIV who use substances reported willingness to use DPS to measure PrEP adherence in a research context, and identified benefits to accessing real-time, DPS-detected adherence data.

BackgroundPromoting health behaviors and preventing chronic diseases through a healthy lifestyle among those with a low socioeconomic status (SES) remain major challenges. eHealth interventions are a promising approach to change unhealthy behaviors in this target group. ObjectiveThis review aims to identify key components, barriers, and facilitators in the development, reach, use, evaluation, and implementation of eHealth lifestyle interventions for people with a low SES. This review provides an overview for researchers and eHealth developers, and can assist in the development of eHealth interventions for people with a low SES. MethodsWe performed a scoping review based on Arksey and O’Malley’s framework. A systematic search was conducted on PubMed, MEDLINE (Ovid), Embase, Web of Science, and the Cochrane Library, using terms related to a combination of the following key constructs: eHealth, lifestyle, low SES, development, reach, use, evaluation, and implementation. There were no restrictions on the date of publication for articles retrieved upon searching the databases. ResultsThe search identified 1323 studies, of which 42 met our inclusion criteria. An update of the search led to the inclusion of 17 additional studies. eHealth lifestyle interventions for people with a low SES were often delivered via internet-based methods (eg, websites, email, Facebook, and smartphone apps) and offline methods, such as texting. A minority of the interventions combined eHealth lifestyle interventions with face-to-face or telephone coaching, or wearables (blended care). We identified the use of different behavioral components (eg, social support) and technological components (eg, multimedia) in eHealth lifestyle interventions. Facilitators in the development included iterative design, working with different disciplines, and resonating intervention content with users. Facilitators for intervention reach were use of a personal approach and social network, reminders, and self-monitoring. Nevertheless, barriers, such as technological challenges for developers and limited financial resources, may hinder intervention development. Furthermore, passive recruitment was a barrier to intervention reach. Technical difficulties and the use of self-monitoring devices were common barriers for users of eHealth interventions. Only limited data on barriers and facilitators for intervention implementation and evaluation were available. ConclusionsWhile we found large variations among studies regarding key intervention components, and barriers and facilitators, certain factors may be beneficial in building and using eHealth interventions and reaching people with a low SES. Barriers and facilitators offer promising elements that eHealth developers can use as a toolbox to connect eHealth with low SES individuals. Our findings suggest that one-size-fits-all eHealth interventions may be less suitable for people with a low SES. Future research should investigate how to customize eHealth lifestyle interventions to meet the needs of different low SES groups, and should identify the components that enhance their reach, use, and effectiveness.

Biodiversity is in a state of global collapse. Among the main drivers of this crisis is habitat degradation that destroys living spaces for animals, birds, and other species. Design and provision of human-made replacements for natural habitat structures can alleviate this situation. Can emerging knowledge in ecology, design, and artificial intelligence (AI) help? Current strategies to resolve this issue include designing objects that reproduce known features of natural forms. For instance, conservation practitioners seek to mimic the function of rapidly disappearing large old trees by augmenting utility poles with perch structures. Other approaches to restoring degraded ecosystems employ computational tools to capture information about natural forms and use such data to monitor remediation activities. At present, human-made replacements of habitat structures cannot reproduce significant features of complex natural forms while supporting efficient construction at large scales. We propose an AI agent that can synthesise simplified but ecologically meaningful representations of 3D forms that we define as visual abstractions. Previous research used AI to synthesise visual abstractions of 2D images. However, current applications of such techniques neither extend to 3D data nor engage with biological conservation or ecocentric design. This article investigates the potential of AI to support the design of artificial habitat structures and expand the scope of computation in this domain from data analysis to design synthesis. Our case study considers possible replacements of natural trees. The application implements a novel AI agent that designs by placing three-dimensional cubes – or voxels – in the digital space. The AI agent autonomously assesses the quality of the resulting visual abstractions by comparing them with three-dimensional representations of natural trees. We evaluate the forms produced by the AI agent by measuring relative complexity and features that are meaningful for arboreal wildlife. In conclusion, our study demonstrates that AI can generate design suggestions that are aligned with the preferences of arboreal wildlife and can support the development of artificial habitat structures. The bio-informed approach presented in this article can be useful in many situations where incomplete knowledge about complex natural forms can constrain the design and performance of human-made artefacts.

The Moon of our Earth has a tenuous atmosphere, known as an exosphere. The ionization of this exosphere is speculated to possibly form a weak ionosphere. Some radio occultation (RO) experiments have suggested the presence of a dense ionosphere with an electron density on the order of hundreds of cm ^−3 near the surface. Using in situ measurements from the ARTEMIS mission during 2012–2021, we conduct statistical analyses and case studies to investigate the plasma density at near-surface altitudes. ARTEMIS measurements reveal no plasma densities at altitudes between 10 and 50 km that exceed 35 cm ^−3 , and therefore they provide no evidence for a steady-state or global lunar ionosphere at the level suggested by some RO observations. Density profiles with local time and altitude show higher density in the sunlit sector than in the shadowed sector. These observations suggest that the natural variation of solar wind plasma flux with solar zenith angle plays a critical role in controlling the plasma population near the surface. This research provides a reference for a comparison with RO observations and a statistical view of the low-altitude plasma environment near the lunar surface.

Parker Solar Probe observes unexpectedly prevalent switchbacks, which are rapid magnetic field reversals that last from seconds to hours, in the inner heliosphere, posing new challenges to understanding their nature, origin, and evolution. In this work, we investigate the thermal states, electron pitch-angle distributions, and pressure signatures of both inside and outside the switchbacks, separating a switchback into spike, transition region (TR), and quiet period (QP). Based on our analysis, we find that the proton temperature anisotropies in TRs seem to show an intermediate state between spike and QP plasmas. The proton temperatures are more enhanced in the spike than in the TR and QP, but the alpha temperatures and alpha-to-proton temperature ratios show the opposite trend to the proton temperatures, implying that the preferential heating mechanisms of protons and alphas are competing in different regions of switchbacks. Moreover, our results suggest that the electron-integrated intensities are almost the same across the switchbacks, but the electron pitch-angle distributions are more isotropic inside than outside switchbacks, implying switchbacks are intact structures, but strong scattering of electrons happens inside switchbacks. In addition, the examination of pressures reveals that the total pressures are comparable through an individual switchback, confirming switchbacks are pressure-balanced structures. These characteristics could further our understanding of ion heating, electron scattering, and the structure of switchbacks.

This paper addresses the first direct investigation of the energy budget in the solar corona. Exploiting joint observations of the same coronal plasma by Parker Solar Probe and the Metis coronagraph aboard Solar Orbiter and the conserved equations for mass, magnetic flux, and wave action, we estimate the values of all terms comprising the total energy flux of the proton component of the slow solar wind from 6.3 to 13.3 R _⊙ . For distances from the Sun to less than 7 R _⊙ , we find that the primary source of solar wind energy is magnetic fluctuations including Alfvén waves. As the plasma flows away from the low corona, magnetic energy is gradually converted into kinetic energy, which dominates the total energy flux at heights above 7 R _⊙ . It is found too that the electric potential energy flux plays an important role in accelerating the solar wind only at altitudes below 6 R _⊙ , while enthalpy and heat fluxes only become important at even lower heights. The results finally show that energy equipartition does not exist in the solar corona.

The heating and acceleration of the solar wind remains one of the unsolved fundamental problems in heliophysics. It is usually observed that the proton temperature T _i is highly correlated with the solar wind speed V _SW , while the electron temperature T _e shows anticorrelation or no clear correlation with the solar wind speed. Here, we inspect both Parker Solar Probe (PSP) and WIND data, and compare the observations with simulation results. PSP observations below 30 solar radii clearly show a positive correlation between the proton temperature and the wind speed and a negative correlation between the electron temperature and the wind speed. One year (2019) of WIND data confirm that the proton temperature is positively correlated with the solar wind speed, but the electron temperature increases with the solar wind speed for slow wind, while it decreases with the solar wind speed for fast wind. Using a 1D Alfvén-wave-driven solar wind model with different proton and electron temperatures, we find, for the first time, that if most of the dissipated Alfvén wave energy heats the ions instead of the electrons, a positive T _i – V _SW correlation and a negative T _e – V _SW correlation arise naturally. If the electrons gain a small but finite portion of the dissipated wave energy, the T _e – V _SW correlation evolves with the radial distance to the Sun, such that the negative correlation gradually turns positive. The model results show that Alfvén waves are one of the possible explanations for the observed evolution of the proton and electron temperatures in the solar wind.

This study investigated the effectiveness of the Hanen More Than Words® (HMTW) program amongst parents of children with autism spectrum disorder (ASD) in Hong Kong. In this prospective cohort study, 31 Cantonese-speaking young children with ASD and their parents were divided into either the HMTW group (n = 26) or a control group (n = 5). The HMTW intervention was provided over 11 weeks. The children’s communication abilities were measured prior to the intervention (Time 1) and 1 month after the end of the intervention (Time 2), and the results were compared between the two groups. The parents’ attributes and demographic information were measured at Time 1. The results showed a significant increase in children’s communication and social skills in the HMTW group compared with the control group. Children of parents with lower levels of Time 1 parenting self-efficacy exhibited facilitated growth in communication and social skills. These findings provide evidence of the effectiveness of the HMTW program in a Chinese cultural setting and demonstrate an important link between parenting self-efficacy and the effectiveness of the HMTW program.

Low socioeconomic status (SES) is associated with a higher prevalence of unhealthy lifestyles compared to a high SES. Health interventions that promote a healthy lifestyle, like eHealth solutions, face limited adoption in low SES groups. To improve the adoption of eHealth interventions, their alignment with the target group's attitudes is crucial. This study investigated the attitudes of people with a low SES toward health, healthcare, and eHealth. We adopted a mixed-method community-based participatory research approach with 23 members of a community center in a low SES neighborhood in the city of Rotterdam, the Netherlands. We conducted a first set of interviews and analyzed these using a grounded theory approach resulting in a group of themes. These basic themes' representative value was validated and refined by an online questionnaire involving a different sample of 43 participants from multiple community centers in the same neighborhood. We executed three focus groups to validate and contextualize the results. We identified two general attitudes based on nine profiles toward health, healthcare, and eHealth. The first general attitude, optimistically engaged, embodied approximately half our sample and involved light-heartedness toward health, loyalty toward healthcare, and eagerness to adopt eHealth. The second general attitude, doubtfully disadvantaged, represented roughly a quarter of our sample and was related to feeling encumbered toward health, feeling disadvantaged within healthcare, and hesitance toward eHealth adoption. The resulting attitudes strengthen the knowledge of the motivation and behavior of people with low SES regarding their health. Our results indicate that negative health attitudes are not as evident as often claimed. Nevertheless, intervention developers should still be mindful of differentiating life situations, motivations, healthcare needs, and eHealth expectations. Based on our findings, we recommend eHealth should fit into the person's daily life, ensure personal communication, be perceived usable and useful, adapt its communication to literacy level and life situation, allow for meaningful self-monitoring and embody self-efficacy enhancing strategies.

Time-series measurements of the number density ncore and temperature Tcore of the core-electron population of the solar wind are examined at 1 AU and at 0.13 AU using measurements from the WIND and Parker Solar Probe spacecraft, respectively. A statistical analysis of the ncore and Tcore measurements at 1 AU finds that the core-electron spatial structure of the solar wind is related to the magnetic-flux-tube structure of the solar wind; this electron structure is characterized by jumps in the values of ncore and Tcore when passing from one magnetic flux tube into the next. The same types of flux-tube jumps are seen for Tcore at 0.13 AU. Some models of the interplanetary electrical potential of the heliosphere predict that Tcore is a direct measure of the local electrical potential in the heliosphere. If so, then jumps seen in Tcore represent jumps in the electrical potential from flux tube to flux tube. This may imply that the interplanetary electrical potential (and its effect on the radial evolution away from the Sun of solar-wind ions and electrons) independently operates in each flux tube of the heliosphere.

No abstract available. Article truncated after 150 words. History of Present Illness: A 34-year-old man with a history of IV drug abuse was brought into emergency department by EMS and Tucson Police Department after complaints of naked man running and behaving erratically in a park. On arrival to emergency department patient was acting aggressively towards staff, spitting and attempting to bite. The ER staff attempted multiple times to sedate the patient with benzodiazepines, however, due to continued aggressive behavior, ongoing encephalopathy and the need for increased sedation, the patient was intubated for airway protection. The patient was febrile (40.6° C), tachycardic (122) and hypertensive (143/86). On physical exam patient was not cooperative, was diaphoretic, cachectic, with reactive constrictive pupils, track marks in antecubital fossa bilaterally. No clonus or hypertonicity. During intubation, there was noted to be nuchal rigidity. He was then admitted to the medical ICU. Drug intoxication from possible methamphetamines was the presumptive diagnosis of encephalopathy but …

Summary: Background: Death and injury due to motor vehicle crashes is the world's fifth leading cause of mortality and morbidity. City and urban designs might play a role in mitigating the global burden of road transport injury to an extent that has not been captured by traditional safe system approaches. We aimed to determine the relationship between urban design and road trauma across the globe. Methods: Applying a combined convolutional neural network and graph-based approach, 1692 cities capturing one third of the world's population were classified into types based on urban design characteristics represented in sample maps. Associations between identified city types, characteristics contained within sample maps, and the burden of road transport injury as measured by disability adjusted life-years were estimated through univariate and multivariate analyses, controlling for the influence of economic activity. Findings: Between Mar 1, 2017, and Dec 24, 2018, nine global city types based on a final sample of 1632 cities were identified. Burden of road transport injury was an estimated two-times higher (risk ratio 2·05, 95% CI 1·84–2·27) for the poorest performing city type compared with the best performing city type, culminating in an estimated loss of 8·71 (8·08–9·25) million disability-adjusted life-years per year attributable to suboptimal urban design. City types that featured a greater proportion of railed public transport networks combined with dense road networks characterised by smaller blocks showed the lowest rates of road traffic injury. Interpretation: This study highlights the important role that city and urban design plays in mitigating road transport injury burden at a global scale. It is recommended that road and transport safety efforts promote urban design that features characteristics inherent in identified high-performance city types including higher density road infrastructure and high rates of public transit. Funding: See acknowledgments.

IntroductionHPTN 083 demonstrated the superiority of long-acting cabotegravir (CAB-LA) versus daily oral emtricitabine/tenofovir disoproxil fumarate (TDF/FTC) as pre-exposure prophylaxis (PrEP) among cisgender men and transgender women who have sex with men (MSM/TGW). HPTN 083 provided the first opportunity to understand experiences with injectable PrEP in a clinical trial.MethodsParticipants from two US sites (Chicago, IL and Atlanta, GA) and one international site (Rio de Janeiro, Brazil) were purposively sampled for individual qualitative interviews (N = 40), between November 2019 and March 2020, to explore trial experiences, barriers to adherence and other factors that may have impacted study implementation or outcomes. The blinded phase ended early due to efficacy; this analysis includes interviews conducted prior to unblinding with three groups defined by adherence (i.e. injection visit attendance): adherent (n = 27), non-adherent (n = 12) and early discontinuers (n = 1). Data were organized using NVivo software and analysed using content analysis.ResultsParticipants (mean age: 27) were primarily cisgender MSM (90%) and Black/African American (60%). Reasons for trial enrolment and PrEP use included a preference for using HIV prevention medication versus treatment in the event of HIV acquisition; the ability to enhance health via study-related education and services; access to a novel, convenient HIV prevention product at no cost; and contributing to MSM/TGW communities through research. Participants contrasted positive experiences with study staff with their routine clinical care, and emphasized increased scheduling flexibility, thorough communication, non-judgemental counselling and open, affirming environments (e.g. compassion, less stigma) as adherence facilitators. Injection experiences were positive overall; some described early injection-related anxiety, which abated with time and when given some measure of control (e.g. pre-injection countdown), and minimal injection site discomfort. Some concerns and misperceptions about injectable PrEP were reported. Barriers to adherence, across all adherence categories, included structural factors (e.g. financial constraints, travel) and competing demands (e.g. work schedules).ConclusionsRespondents viewed injectable PrEP trial participation as a positive experience and a means of enhancing wellbeing. Study site flexibility and affirming clinic environments, inclusive of non-judgemental counselling, were key facilitators of adherence. To support injection persistence, interventions that address structural barriers and promote flexible means of injection delivery may be most effective.

Summary: In vitro drug tests using patient-derived stem cell cultures offer opportunities to individually select efficacious treatments. Here, we provide a study that demonstrates that in vitro drug responses in rectal organoids from individual patients with cystic fibrosis (CF) correlate with changes in two in vivo therapeutic endpoints. We measured individual in vitro efficaciousness using a functional assay in rectum-derived organoids based on forskolin-induced swelling and studied the correlation with in vivo effects. The in vitro organoid responses correlated with both change in pulmonary response and change in sweat chloride concentration. Receiver operating characteristic curves indicated good-to-excellent accuracy of the organoid-based test for defining clinical responses. This study indicates that an in vitro assay using stem cell cultures can prospectively select efficacious treatments for patients and suggests that biobanked stem cell resources can be used to tailor individual treatments in a cost-effective and patient-friendly manner. : Berkers et al. demonstrate that stem cell cultures (organoids) can be a tool for personalized medicine. They show a high correlation between in vitro and in vivo effects of drugs and demonstrate good-to-excellent predictive values of the organoid test for preclinical identification of responders to CFTR modulators. Keywords: organoids, personalized treatment, predicting, drug response, stem cell cultures, cystic fibrosis, CFTR

Urban typologies allow areas to be categorised according to form and the social, demographic, and political uses of the areas. The use of these typologies and finding similarities and dissimilarities between cities enables better targeted interventions for improved health, transport, and environmental outcomes in urban areas. A better understanding of local contexts can also assist in applying lessons learned from other cities. Constructing urban typologies at a global scale through traditional methods, such as functional or network analysis, requires the collection of data across multiple political districts, which can be inconsistent and then require a level of subjective classification. To overcome these limitations, we use neural networks to analyse millions of images of urban form (consisting of street view, satellite imagery, and street maps) to find shared characteristics between the largest 1692 cities in the world. The comparison city of Paris is used as an exemplar and we perform a case study using two Australian cities, Melbourne and Sydney, to determine if a “Paris-end” of town exists or can be found in these cities using these three big data imagery sets. The results show specific advantages and disadvantages of each type of imagery in constructing urban typologies. Neural networks trained with map imagery will be highly influenced by the structural mix of roads, public transport, and green and blue space. Satellite imagery captures a combination of both urban form and decorative and natural details. The use of street view imagery emphasises the features of a human-scaled visual geography of streetscapes. However, for both satellite and street view imagery to be highly effective, a reduction in scale and more aggressive pre-processing might be required in order to reduce detail and create greater abstraction in the imagery.

The American monkfish is an important commercial species that is widely distributed across a range of depths and temperatures from North Carolina to southern Nova Scotia, including on Georges Bank. We examined changes in the seasonal distribution and relative abundance of monkfish in the scallop access areas in Closed Area I and Closed Area II on Georges Bank using catch data from a three-year seasonal scallop dredge survey. Over the course of the survey, more than 6,000 monkfish were caught and measured, and clear seasonal changes in monkfish abundance were documented. Monkfish catch peaked in the summer and early fall when they were caught across the entire survey area, while they were caught only in deeper waters at the edges of the bank in the winter. Monkfish relative abundance was modeled using a generalized linear mixed model with a Tweedie distribution, and the final model, with month, depth, and bottom temperature as fixed effects, effectively explained the seasonal shifts in the location and relative abundance of monkfish observed during this study. The results suggest that monkfish movements are driven by seasonal changes in bottom temperature. Management measures for monkfish are determined primarily based on data collected during the Northeast Fisheries Science Center bottom trawl surveys, yet this survey catches few monkfish, adding uncertainty to stock assessments. Our research indicates that increasing the use of dredge surveys to collect data on monkfish would be a positive step toward improving monkfish assessments. If monkfish movements are impacted by changes in thermal habitat, their distributions may shift in response to climate change, increasing the need for improved monkfish assessment strategies to effectively manage the species in the future.

The frequency of cardiovascular disorders is increasing in HIV-infected individuals despite a significant reduction in the viral load by antiretroviral therapies (ART). Since the CD4+ T-cells are responsible for the viral load as well as immunological responses, we hypothesized that chronic HIV-infection of T-cells produces novel proteins/enzymes that cause cardiac dysfunctions. To identify specific factors that might cause cardiac disorders without the influence of numerous cofactors produced by other pathogenic microorganisms that co-inhabit most HIV-infected individuals, we analyzed genome-wide proteomes of a CD4+ T-cell line at different stages of HIV replication and cell growth over >6 months. Subtractive analyses of several hundred differentially regulated proteins from HIV-infected and uninfected counterpart cells and comparisons with proteins expressed from the same cells after treating with the antiviral drug Zidovudine/AZT and inhibiting virus replication, identified a well-coordinated network of 12 soluble/diffusible proteins in HIV-infected cells. Functional categorization, bioinformatics and statistical analyses of each protein predicted that the expression of cardiac-specific Ca2+ kinase together with multiple Ca2+ release channels causes a sustained overload of Ca2+ in the heart which induces fetal/cardiac myosin heavy chains (MYH6 and MYH7) and a myosin light-chain kinase. Each of these proteins has been shown to cause cardiac stress, arrhythmia, hypertrophic signaling, cardiomyopathy and heart failure (p = 8 × 10−11). Translational studies using the newly discovered proteins produced by HIV infection alone would provide additional biomarkers that could be added to the conventional markers for an early diagnosis and/or development of specific therapeutic interventions for heart diseases in HIV-infected individuals.