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Imaging in the second near-infrared window has attracted attention due to superior penetration depth and low signal interference. Here, the authors describe a new organic nano fluorophore with high quantum yield and demonstrate its use for in vivo imaging.

Background: Pain plays a significant role in emergency department (ED) visits, however safe and effective nonpharmacologic options are needed. Prior studies of acupuncture in the ED reported pain reduction with minimal side effects, but most were small and single site. Methods: We conducted ACUITY, a prospectively designed multi-center feasibility RCT. Our goal was to recruit 165 adults with acute non-emergent pain ≥4 on a 0–10-point scale at three EDs affiliated with BraveNet Practice Based Research Network. At baseline and 45–60 min later (post), participants self-assessed their pain and anxiety using a 0–10 rating scale. The primary feasibility outcome was recruitment of participants, whereas secondary outcomes were retention, and participant/provider acceptability. Results: From May 3, 2021, to September 24, 2022, 632 eligible individuals were approached and 165 enrolled (165/632: 26.1 %), meeting our recruitment goal. Notably, 42.4 % of enrollees were Black/African American, 42.4 % were White/Caucasian, and 13.9 % were Hispanic/Latino. Participants were randomized to Acupuncture (n = 83) or Usual care (n = 82), of which 151 (91.5 %) and 128 (77.6 %) provided pain and anxiety scores at post-treatment and 1-week respectively. Acupuncture was rated acceptable to participants and providers. Mean pain ratings (pre-to-post) were 7.4 (2.2) to 4.8 (2.8) for acupuncture and 7.1 (2.3) to 6.4 (2.5) for usual care. Mean anxiety ratings (pre-to-post) were 4.5 (3.4) to 2.5 (2.6) for acupuncture and 4.1 (3.4) to 3.5 (3.2) for usual care. Conclusion: Successful completion of ACUITY indicates we have the expertise and preliminary data to conduct a future definitive, multi-center RCT. Trial registration: Clinical trials.gov: NCT04880733.

Abstract The studies on the forest sector focus on energy issues and environmental challenges, but they are limited to a small number of studies focused on economic growth and social welfare. In the forest sector, Brazil is among the five countries with large forest cover in the world, with favorable conditions and great potential for production growth. Therefore, this work aimed to measure the evolution of efficiency and productivity of the 49 Brazilian forestry microregions in converting the expansion of economic growth into social welfare from 2009 to 2015 (a period of sectoral growth in the country). The approach of the Slack-Based Measure (SBM) – Data Envelopment Analysis (DEA), Malmquist Productivity Index (MPI), and Windows Analysis model was combined, followed by a solution for infeasibility problems. The results show that the growth of the forestry sector was not accompanied by the Human Development Index (HDI) in most of the microregions, showing regional and state differences, with the microregions close to the sensitive environmental areas with the lowest HDI. Thus, the work contributes to the design of public policies and government decision-making to increase the sector's efficiency and productivity and to social indicators that can guide sustainable policies in other contexts and countries.

The structure and chemistry of the dusty interstellar medium (ISM) are shaped by complex processes that depend on the local radiation field, gas composition, and dust grain properties. Of particular importance are polycyclic aromatic hydrocarbons (PAHs), which emit strong vibrational bands in the mid-infrared, and play a key role in the ISM energy balance. We recently identified global correlations between PAH band and optical line ratios across three nearby galaxies, suggesting a connection between PAH heating and gas ionization throughout the ISM. In this work, we perform a census of the PAH heating–gas ionization connection using ∼700,000 independent pixels that probe scales of 40–150 pc in 19 nearby star-forming galaxies from the PHANGS survey. We find a universal relation between $\mathrm{log}$ PAH(11.3 μ m/7.7 μ m) and $\mathrm{log}$ ([S ii ]/H α ) with a slope of ∼0.2 and a scatter of ∼0.025 dex. The only exception is a group of anomalous pixels that show unusually high (11.3 μ m/7.7 μ m) PAH ratios in regions with old stellar populations and high starlight-to-dust emission ratios. Their mid-infrared spectra resemble those of elliptical galaxies. Active galactic nucleus hosts show modestly steeper slopes, with a ∼​​​​​​10% increase in PAH(11.3 μ m/7.7 μ m) in the diffuse gas on kiloparsec scales. This universal relation implies an emerging simplicity in the complex ISM, with a sequence that is driven by a single varying property: the spectral shape of the interstellar radiation field. This suggests that other properties, such as gas-phase abundances, gas ionization parameter, and grain charge distribution, are relatively uniform in all but specific cases.

The L’Ralph instrument is a key component of NASA’s Lucy mission, intended to provide spectral image data of multiple Jupiter Trojans. The instrument operates from ∼0.35 to 4 μ m using two focal plane assemblies: a 350–950 nm multispectral imager, Multi-spectral Visible Imaging Camera (MVIC), and a 0.97–4 μ m imaging spectrometer, Linear Etalon Imaging Spectral Array (LEISA). Instrument calibration was established through ground testing before launch and has been monitored during cruise utilizing internal calibration sources and stellar targets. In-flight data have shown that the instrument thermal performance is exceeding expectations, allowing for early updates to LEISA radiometric and pointing calibrations. MVIC radiometric performance remains stable more than 3 yr since launch. The serendipitous identification of a new flyby target, (152830) Dinkinesh, allowed testing of instrument performance and interleaved LEISA and MVIC acquisitions on an asteroid target. Both MVIC and LEISA obtained data of Dinkinesh and its moon, Selam, demonstrating that they show good spectral agreement with an S- or Sq-type asteroid, along with evidence of a 3 μ m absorption feature.

Introducción: el desarrollo de actividades académicas a través de espacios virtuales contribuye a incrementar el uso de Smartphones en los universitarios, surgiendo la necesidad de estudiar los efectos de su uso. Objetivo: evaluar el efecto mediador de la distracción por Smartphone entre el tecnoestrés y la adicción a los Smartphone en universitarios de Lima Metropolitana. Método: Una muestra de 550 universitarios, con edades entre 18 y 35 años, fue evaluada con la Escala de distracción por Smartphone, la Escala de tecnoestrés para universitarios y la Escala de adicción basada en aplicaciones para teléfonos inteligentes. Se realizó un análisis de regresión para evaluar el rol mediador de la distracción por smartphones en la relación explicativa entre el tecnoestrés y la adicción a los celulares. Resultados: se identificó un efecto completo por parte del mediador, además se observa que existe un efecto indirecto del tecnoestrés sobre la adicción al smartphone. Discusión: la distracción por smartphone tiene un efecto sobre la adicción a los teléfonos celulares siempre y cuando esté presente la distracción como mediador.

Background: Previous studies have shown isokinetic exercise forms an important part in reconditioning the patients after anterior cruciate ligament reconstruction (ACLR) in regaining muscle strength and knee function. Although eccentric isokinetic training has been shown to enhance quadriceps muscle strength, the application toward benefiting patients after ACLR remains controversial. The present study aims to investigate the benefits of eccentric over concentric isokinetic exercises on knee muscle strength and its value in later stage of rehabilitation, including the return-to-sport. Methods: Thirty-six patients who had undergone ACLR for 4-to-6 months were assigned to receive either eccentric or concentric isokinetic training weekly for six weeks on top of their standardized post-operative exercise programme. The assessments include isokinetic test on the peak torques of quadriceps and hamstrings, single-leg hop test and ability to return-to-sport. Results: Both groups demonstrated significant gains on peak torques in quadriceps and hamstrings after training. At post-intervention, the peak torques for both quadriceps (p = 0.005) and hamstrings (p = 0.017) of the ACL-reconstructed limb from eccentric training were significantly higher than concentric training. The significant improvement was similarly demonstrated in the limb symmetry index (LSI) in hamstrings (p = 0.016) of the ACL-reconstructed limb from eccentric training. Moreover, eccentric group performed significantly better in single-leg hop tests (p = 0.042). Most importantly, eccentric group have higher percentages of return-to-sport (55.6 %) than concentric group (27.8 %). Conclusion: A 6-week course of eccentric isokinetic training was more effective than concentric isokinetic training in increasing quadriceps and hamstrings strength in terms of peak torques. Importantly, the better functional performance after the eccentric isokinetic exercise account for higher return-to-sport ratio.

Beginning in 2022, Nuevo Leon, Mexico, experienced an outbreak of rickettsioses that is still ongoing despite multidisciplinary control efforts. A total of 57 cases have been confirmed, particularly affecting children. We report a high mortality rate among hospitalized persons in Nuevo Leon. Continuing efforts are required to control the outbreak.

Abstract Spatial transcriptomics of histological sections have revolutionized research in life sciences and enabled unprecedented insights into genetic processes involved in tissue reorganization. However, in contrast to genomic analysis, the actual biomolecular composition of the sample has fallen behind, leaving a gap of potentially highly valuable information. Raman microspectroscopy provides untargeted spatiomolecular information at high resolution, capable of filling this gap. In this study we demonstrate spatially resolved Raman “spectromics” to reveal homogeneity, heterogeneity and dynamics of cell matrix on molecular levels by repurposing state-of-the-art bioinformatic analysis tools commonly used for transcriptomic analyses. By exploring sections of murine myocardial infarction and cardiac hypertrophy, we identify myocardial subclusters when spatially approaching the pathology, and define the surrounding metabolic and cellular (immune-) landscape. Our innovative, label-free, non-invasive “spectromics” approach could therefore open perspectives for a profound characterization of histological samples, while additionally allowing the combination with consecutive downstream analyses of the very same specimen.

[This corrects the article DOI: 10.1371/journal.pone.0265879.].

Em agosto de 2020 foi sancionada a Lei Geral de Proteção de Dados (LGPD), representando o marco regulatório no âmbito da proteção de dados. Em decorrência do que a lei dispõe sobre a responsabilidade civil, foram elaboradas diferentes correntes doutrinárias a respeito do tema, surgindo debates controversos com a finalidade de responder à seguinte indagação: se o regime de responsabilidade civil adotado pela LGPD é objetivo ou subjetivo. Sendo assim, esse estudo possui a finalidade de examinar o sistema de responsabilidade civil aplicado aos agentes de tratamento na Lei Geral de Proteção de Dados (Lei 13.709/18), apresentando uma análise crítica sobre os dispositivos que regem o tema responsabilidade civil, à luz dos diferentes pontos de vista dos doutrinadores brasileiros sobre os regimes de responsabilidade civil e sua possível aplicabilidade na Lei Geral de Proteção de Dados.

Background: Dilated cardiomyopathy with ataxia (DCMA) is an autosomal recessive disorder arising from truncating mutations in DNAJC19, which encodes an inner mitochondrial membrane protein. Clinical features include an early onset, often life-threatening, cardiomyopathy associated with other metabolic features. Here, we aim to understand the metabolic and pathophysiological mechanisms of mutant DNAJC19 for the development of cardiomyopathy. Methods: We generated induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) of two affected siblings with DCMA and a gene-edited truncation variant (tv) of DNAJC19 which all lack the conserved DnaJ interaction domain. The mutant iPSC-CMs and their respective control cells were subjected to various analyses, including assessments of morphology, metabolic function, and physiological consequences such as Ca2+ kinetics, contractility, and arrhythmic potential. Validation of respiration analysis was done in a gene-edited HeLa cell line (DNAJC19tvHeLa). Results: Structural analyses revealed mitochondrial fragmentation and abnormal cristae formation associated with an overall reduced mitochondrial protein expression in mutant iPSC-CMs. Morphological alterations were associated with higher oxygen consumption rates (OCRs) in all three mutant iPSC-CMs, indicating higher electron transport chain activity to meet cellular ATP demands. Additionally, increased extracellular acidification rates suggested an increase in overall metabolic flux, while radioactive tracer uptake studies revealed decreased fatty acid uptake and utilization of glucose. Mutant iPSC-CMs also showed increased reactive oxygen species (ROS) and an elevated mitochondrial membrane potential. Increased mitochondrial respiration with pyruvate and malate as substrates was observed in mutant DNAJC19tv HeLa cells in addition to an upregulation of respiratory chain complexes, while cellular ATP-levels remain the same. Moreover, mitochondrial alterations were associated with increased beating frequencies, elevated diastolic Ca2+ concentrations, reduced sarcomere shortening and an increased beat-to-beat rate variability in mutant cell lines in response to β-adrenergic stimulation. Conclusions: Loss of the DnaJ domain disturbs cardiac mitochondrial structure with abnormal cristae formation and leads to mitochondrial dysfunction, suggesting that DNAJC19 plays an essential role in mitochondrial morphogenesis and biogenesis. Moreover, increased mitochondrial respiration, altered substrate utilization, increased ROS production and abnormal Ca2+ kinetics provide insights into the pathogenesis of DCMA-related cardiomyopathy.

Background: Healthy aging and well-being are largely influenced by nutrition. Objective: The objective of the study was to evaluate the risk of malnutrition in elderly women residing in institutional care and its contributing factors. Methodology: One hundred institutionalized women aged 60 years and above were screened for malnutrition using Mini Nutritional Assessment (MNA) tool. Details on sociodemographic profile, physical activity, medical conditions, and food habits were gathered through researcher administered survey method. Results: The study participants had an average height of 149.70 cm (±7.31), weight of 50.72 kg (±9.11), body mass index of 22.77 kg/m2 (±4.68), body fat percentage of 31.30% (±8.99), mid-arm circumference of 27.36 cm (±7.84), calf circumference of 30.11 cm (±7.51), MNA score of 10.42 (±4.06), and hand grip strength score of 18.69 kg/lbs (±3.80). Upon analyzing the MNA scores, it was found that 9% of elderly women were well nourished, 62% were at risk of malnutrition, and 29% were malnourished. A significant difference was observed in the mean MNA scores (P < 0.05). Age, education level, body fat percentage, appetite, and dental problems were significantly associated with malnutrition (P < 0.05). Conclusion: Geriatric residents in old-age homes require adequate nutrition to maintain health. This can be achieved by providing individualized meal planning, reducing barriers to eating, and incorporating nutrient-dense foods.

Objectives To provide an integrated analysis of major adverse cardiovascular events (MACEs) and events of venous thromboembolism (VTE) and associated risk factors across rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) phase 2b/3 upadacitinib clinical programmes.Methods Data were analysed and summarised from clinical trials of RA, PsA and AS treated with upadacitinib 15 mg once daily (QD) and 30 mg QD (as of 30 June 2021). Data from adalimumab (RA and PsA) and methotrexate (RA) arms were included as comparators. Adjudicated MACEs and VTE events were presented as exposure-adjusted rates per 100 patient-years (E/100 PY). Univariable Cox proportional hazard regression analyses assessed potential associations of risk factors for MACE and VTE.Results In total, 4298 patients received upadacitinib 15 mg (RA n=3209, PsA n=907 and AS n=182) and 2125 patients received upadacitinib 30 mg (RA n=1204 and PsA n=921). In patients with RA and PsA, rates of MACE (0.3–0.6 E/100 PY) and VTE (0.2–0.4 E/100 PY) were similar across upadacitinib doses; in patients with AS, no MACEs and one VTE event occurred. Most patients experiencing MACEs or VTE events had two or more baseline cardiovascular risk factors. Across RA and PsA groups, rates of MACEs and VTE events were similar.Conclusions Rates of MACEs and VTE events with upadacitinib were consistent with previously reported data for patients receiving conventional synthetic and biologic disease-modifying anti-rheumatic drugs and comparable with active comparators adalimumab and methotrexate. Associated patient characteristics are known risk factors for MACEs and VTE events.Trial registration numbers RA (SELECT-NEXT: NCT02675426; SELECT-MONOTHERAPY: NCT02706951; SELECT-BEYOND: NCT02706847; SELECT-COMPARE: NCT02629159; SELECT-EARLY: NCT02706873, SELECT-CHOICE: NCT03086343), PsA (SELECT-PsA 2: NCT03104374; SELECT-PsA 1: NCT03104400), and AS (SELECT-AXIS 1: NCT03178487).

Background The increase in the number of autistic children being identified has led to increased demand on public schools to provide high-quality services. Effectively scaling up evidence-based practice (EBP) use for autistic students is challenging, given the complicated organization of special education. Teachers have significant challenges implementing autism EBP with fidelity. Factors such as implementation leadership and climate and attitudes toward EBP are linked to successful EBP use and may vary at different levels of the education system. Examining mechanisms of successful implementation is a critical step to support scale-up. Method In this observational study, conducted from September 2018 to March 2020, California school personnel ( n = 2273) at multiple levels of the system completed surveys related to implementation climate, leadership, and attitudes toward EBP. Data were collected throughout California at the Special Education Local Plan Areas, County Office of Education, and district and school levels from educators and administrators working in public schools supporting autistic students. Multi-level modeling was conducted to characterize implementation readiness. Results Overall, implementation climate and leadership scores are low across levels with regional levels rated more positively than districts or schools. Attitudes toward EBP were moderate, with those working in schools having the poorest ratings and specialists/trainers and related service providers (e.g., speech-language pathologists) having the highest ratings. Conclusions Outcomes provide a unique opportunity to compare implementation factors across organizational levels with a large, statewide sample. These data provide guidance for developing implementation interventions at multiple levels of the education system to increase readiness for effective scale-up of autism EBP in schools. Personnel and leaders at different organizational levels may need differentiated training targeting improved implementation climate and leadership. Personnel within districts and schools may experience a particular benefit from leadership support for EBP implementation.

Die Verknüpfung der Themen Medienbildung, Digitalisierung und Inklusion sowie damit einhergehender didaktische Mehrwerte und Herausforderungen für die Lehrpersonenbildung und das schulische Lernen sind Gegenstand des Beitrags. Im Rahmen des Lehrentwicklungsprojekts «Bildung im Kontext digitaler Medien unter Berücksichtigung von Inklusion» (BIDI) an der Leuphana Universität Lüneburg wurden medienpädagogische Inhalte und Ziele zu inklusiver Medienbildung im bildungswissenschaftlichen Teilstudium im B. A. Lehren und Lernen (Lehramt Grund-/Haupt-/Realschule) ausgeschärft und in ein Modul implementiert. Daran anknüpfend wurden in einem dialogischen Prozess mit ausgewählten Fachdidaktiken inhaltliche Verknüpfungen ausgelotet und bspw. im Rahmen des Profilstudiums «Digitales Lehren und Lernen» im Studiengang strukturell verankert. Flankierend wurde eine mehrperspektivische explorative qualitative Studie durchgeführt, bestehend aus Gruppendiskussionen mit Lehramtsstudierenden, die das Teilmodul Medienbildung absolviert haben, sowie Lehrenden aus den Fachdidaktiken. Das Erkenntnisinteresse der Studie fokussiert die Sichtweisen der Befragten auf die universitäre Lehre sowie auf Chancen und Herausforderungen im Zusammenspiel von Digitalisierung und Inklusion in der Lehrpersonenbildung und in der Schulpraxis. Die Befragten legten den Fokus auf Aspekte der Teilhabe im Zuge von Digitalisierung (u. a. hinsichtlich Medienausstattung, Lernzugängen, medialen Repräsentationen). Weiterhin wurde die Notwendigkeit einer kritisch-reflexiven Auseinandersetzung mit digitalen Medien und die Veränderung von fachlichen Lerngegenständen und Methoden im Zuge der Digitalisierung diskutiert.

Achieving gender equality in agricultural development is fundamental to reductions in global poverty, hunger, and malnutrition. African women make important contributions to farming and food systems; however, their efforts are often hindered by inefficient and inequitable allocations of intrahousehold labor and time that render women time poor. Time poverty is a root cause of women’s marginalization in rural Africa and an important area of inquiry for feminist scholarship. While gendered time use and time poverty have been researched in many different contexts and countries in Africa, significant knowledge gaps remain. Most studies consider women’s time use divorced from gendered relations, and overlook children’s contributions. Other factors which may combine to influence women’s time burden but are often overlooked include seasonality, work intensity, household structure and composition, cultural norms, familial relationships and intrahousehold power dynamics. Further, the majority of research on gendered time use and time poverty in Africa uses quantitative methods applied to secondary data, which presents challenges for critically identifying and characterizing the confluence of various intrahousehold dynamics which impact women’s multiple roles, responsibilities, and consequently their work and time. This study adds important nuance to the existing body of research by offering an in-depth, qualitative assessment of intrahousehold labor allocation, time use, and time poverty amongst women, men, and children living in multi-generational, largely polygamous households reliant on peanut-farming in the Kaolack region of Senegal. Data collection took place in February 2020, with 111 individuals in three villages. We find that individual workload correlates with gender and age, but is further determined by the demographic composition of the household, the roles assumed by the individual and other family members, and the individual’s place within the social hierarchy. Women and girls in Kaolack are clearly at more risk of time poverty due to their dual responsibility for reproductive and productive work, especially during the rainy season. Furthermore, women’s workload in particular changes over the life course as they assume different roles in different life stages. As a result, women with older daughters and, especially, daughters-in-law are significantly less time poor than other women.

Objective: To determine the incidence, outcomes, and evaluate diagnostic modalities for postoperative vocal cord dysfunction (VCD) following cardiothoracic surgery in children. Methods: A prospective mixed-methods study using principles of implementation science was completed. All patients undergoing surgery involving the aortic arch, ductus, or ligamentum arteriosum and vascular rings from September 2019 to December 2020 were enrolled. Patients underwent speech pathology assessment, laryngeal ultrasound, and flexible direct laryngoscopy. Results: Ninety-five patients were eligible for inclusion. The incidence of VCD ranged from 18% to 56% and varied according to procedure group. VCD occurred in 42% of neonates. Repair of hypoplastic aortic arch was associated with increased risk of VCD (57%; P = .002). There was no significant difference in duration of intubation, pediatric intensive care unit stay, or hospital stay. Forty percent children were able to achieve full oral feeding. Children with VCD were more likely to require nasogastric supplementary feeding at discharge (60% vs 36%; P = .044). Sixty-eight percent of patients demonstrated complete resolution of VCD at a median of 97 days postoperatively. Laryngeal ultrasound and speech pathology assessment combined had a sensitivity of 91% in comparison to flexible direct laryngoscopy. Conclusions: VCD occurred in one-third and resolved in two-thirds of patients at a median of 3 months following cardiac surgery. Aortic arch repair carried the highest risk of VCD. VCD adversely influenced feeding. Forty percent of patients achieved full oral feeding before discharge. VCD did not delay intensive care unit or hospital discharge. Speech pathology assessment and laryngeal ultrasound combined was reliable for diagnosis in most patients and was more patient friendly than flexible direct laryngoscopy.