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Genome-wide association studies have uncovered several loci associated with diabetes risk. Here, the authors reanalyse public type 2 diabetes GWAS data to fine map 50 known loci and identify seven new ones, including one near ATGR2 on the X-chromosome that doubles the risk of diabetes in men.

In the originally published version of this Article, the affiliation details for Santi González, Jian’an Luan and Claudia Langenberg were inadvertently omitted. Santi González should have been affiliated with 'Barcelona Supercomputing Center (BSC), Joint BSC-CRG-IRB Research Program in Computational Biology, 08034 Barcelona, Spain’, and Jian’an Luan and Claudia Langenberg should have been affiliated with ‘MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK’. Furthermore, the abstract contained an error in the SNP ID for the rare variant in chromosome Xq23, which was incorrectly given as rs146662057 and should have been rs146662075. These errors have now been corrected in both the PDF and HTML versions of the Article.

Background: The real-world safety of robotic resections after neoadjuvant chemoimmunotherapy remains poorly defined in patients with non-small cell lung cancer. Due to reported increased operative challenges after neoadjuvant immunotherapy, we aim to describe our early institutional experience and outcomes after robotic resection in this clinical context. Methods: We performed a retrospective chart review of patients with non-small cell lung cancer who underwent a robotic lobectomy, comparing patients from June 1, 2022, through October 31, 2023, who were treated with neoadjuvant chemoimmunotherapy consistent with the Checkmate-816 protocol and a control group with upfront resection. Results: A total of 21 patients underwent neoadjuvant chemoimmunotherapy and robotic lobectomy in our cohort, and 64 patients were in the control group. Compared with control, the median tumor size was 3.2 cm vs 2.0 cm (P = .001). The most common clinical stage was IIIA (11 patients, 52%) in the neoadjuvant chemoimmunotherapy group and IA2 in the control group (26 patients, 45%) (P < .001). Operative time was greater in the neoadjuvant chemoimmunotherapy group (224 vs 177 minutes, P = .011). The median quantity of lymph nodes resected in the neoadjuvant chemoimmunotherapy group was greater (21 vs 16.5, P = .042). A R0 resection was achieved in all cases and no conversions to an open lobectomy occurred. Postoperative length of stay was 2 days in both groups (P = .92), and there were similar rates of postoperative air leak (33% vs 48%, P = .23) and acute post-hemorrhagic anemia (19% vs 14%, P = .58). Conclusions: In our cohort, robotic-assisted lobectomy was safe and of comparable quality in the setting of neoadjuvant chemoimmunotherapy.

Background: Pectus excavatum (PE) is the most common congenital chest wall defect and is characterized by the inward displacement of the sternum and costal cartilages. To date, there are limited data on adult patients undergoing the Nuss procedure for PE. This study aimed to assess the complication rate between the pediatric and adult populations and assess the trends in demographics. Methods: Retrospective analysis was conducted using a global health care database, TriNetX. Current Procedural Terminology codes (21742, 21743) were used to identify all patients who underwent Nuss procedures in the years 2004 to 2023. The cohort was then subdivided on the basis of age and sex. These patients were assessed for 30-day and 90-day major and minor postoperative complications, as well as acute pain and chronic postoperative pain. Results: A total of 2843 patients who underwent Nuss repair were identified. Patients aged >18 years had increased hemorrhagic complications (3% vs 0.86% in patients aged 18 years vs 39.1% in patients aged

Abstract Data from commercial off-the-shelf (COTS) wearables leveraged with machine learning algorithms provide an unprecedented potential for the early detection of adverse physiological events. However, several challenges inhibit this potential, including (1) heterogeneity among and within participants that make scaling detection algorithms to a general population less precise, (2) confounders that lead to incorrect assumptions regarding a participant’s healthy state, (3) noise in the data at the sensor level that limits the sensitivity of detection algorithms, and (4) imprecision in self-reported labels that misrepresent the true data values associated with a given physiological event. The goal of this study was two-fold: (1) to characterize the performance of such algorithms in the presence of these challenges and provide insights to researchers on limitations and opportunities, and (2) to subsequently devise algorithms to address each challenge and offer insights on future opportunities for advancement. Our proposed algorithms include techniques that build on determining suitable baselines for each participant to capture important physiological changes and label correction techniques as it pertains to participant-reported identifiers. Our work is validated on potentially one of the largest datasets available, obtained with 8000+ participants and 1.3+ million hours of wearable data captured from Oura smart rings. Leveraging this extensive dataset, we achieve pre-symptomatic detection of COVID-19 with a performance receiver operator characteristic (ROC) area under the curve (AUC) of 0.725 without correction techniques, 0.739 with baseline correction, 0.740 with baseline correction and label correction on the training set, and 0.777 with baseline correction and label correction on both the training and the test set. Using the same respective paradigms, we achieve ROC AUCs of 0.919, 0.938, 0.943 and 0.994 for the detection of self-reported fever, and 0.574, 0.611, 0.601, and 0.635 for detection of self-reported shortness of breath. These techniques offer improvements across almost all metrics and events, including PR AUC, sensitivity at 75% specificity, and precision at 75% recall. The ring allows continuous monitoring for detection of event onset, and we further demonstrate an improvement in the early detection of COVID-19 from an average of 3.5 days to an average of 4.1 days before a reported positive test result.

The mental health of children and adolescents in the Chilean Educational System (ChES) has become a severe post-pandemic public health problem. This cross-sectional study, which included 1,174 children and adolescents from five Chilean regions, used the DASS-21 scale, focusing on determining the prevalence of depression, anxiety, and stress, as well as identifying associated risk factors. The results exposed a high prevalence of depression, anxiety, and stress (60.2%, 63.6%, and 50.2%, respectively). Risk factors for depression involve being female, having separated parents, being in high school, having a cell phone, difficulty sleeping, ruminative thoughts, and low self-esteem. For anxiety, factors included being female, being 12 years old, owning a cell phone, having sleep problems, having ruminations, having low self-esteem, and being an atheist. For stress, factors were identified as being female, owning a cell phone, sleep problems, ruminations, low self-esteem, being atheist, as well as extensive use of social networks. The research underscores the urgent need for intervention by educational authorities, given the marked deterioration in the mental health of children and adolescent students in the ChES, to prevent long-term consequences.

In this article we analyse the opposition between the fear of death and the fear of birth. The politics based on the fear of death implies the construction of a fiction presented and considered as a truth. This fictional truth is sewed within the bodies and generates a ghostly body. The ghost blocks the ongoing birth and therefore facilitates the extension of fear within the bodily tissues and towards the external space. Monsters appear as projection of forgotten body parts. Demons live at the edges of society, which reduces to a minimum the life of its subjects thanks to demoniacal threats. “Terrorist” is today’s word for demon. Continual birth is the last fight, waged by postmodern samurais that live and think the world as a butoh dance.

En este artículo se analiza la oposición entre miedo a la muerte y miedo al nacimiento. La política fundada en el miedo a la muerte implica la elaboración de una ficción que se presenta como una verdad. La verdad ficticia se siembra en los cuerpos y así emerge un cuerpo fantasma. El fantasma impide la continuación del nacimiento, favoreciendo así la ramificación del miedo en los tejidos del cuerpo y hacia el espacio. Aparecen los monstruos como proyección de las partes descuidadas de la existencia. Los demonios viven en los márgenes de la sociedad que reduce al mínimo la vida de sus sujetos, limitándolos a la supervivencia bajo amenazas demoníacas. Terroristas es el nombre contemporáneo para demonios. Seguir naciendo es la última lucha, propia de los samuráis posmodernos que viven y piensan el mundo desde la danza butoh.

Pinyon woodlands in the semi-arid southwestern United States developed in response to environmental factors and historical human interactions, providing sustenance and traditional ecological benefits to Native Nations, such as the Navajo (Diné). Historically, Diné communities practiced land stewardship through seasonal movements and resource management, ensuring ecosystem resilience. However, the constraints imposed by European colonization led to transformative changes in their livelihoods and environments. Encompassing 71,000 km2, pinyon-juniper woodlands comprise 89 % of forested area on the Navajo Nation reservation, providing crucial ecosystem services and cultural resources. Since reservation establishment in 1868, increased tree density has diminished understory plant communities and elevated woodland susceptibility to wildfires, compromising overall forest health. Recognizing the imperative for ecological restoration, a collaborative effort between Diné College and Northern Arizona University (NAU) was established in 2018 to develop a pinyon woodland research site on the Diné College campus in Tsaile, Arizona, on the Navajo Nation reservation. We assessed the effectiveness of restoration thinning treatments in reinstating historical woodland structure, modifying fuels for fire mitigation, and engaging students in ecological practices. Thinning resulted in a 62 % reduction in tree density and a 25 % reduction in basal area, altering the woodland structure to reflect historical conditions more accurately. This alteration mitigated the risk of high-intensity wildfires while preserving the age structure of older trees (oldest dating back to 1435 C.E.). Forest floor fuels were low throughout the study, as thinned wood was removed, and activity fuels were immediately treated with chipping. The active participation of Diné College and NAU students, interns, and faculty throughout the study contributed to a cohesive approach in advancing our goals. The comprehensive training empowered students to contribute meaningfully to fieldwork and data collection, aligning with Diné College's mission to enhance post-secondary student learning and development for the benefit of the Diné. By integrating contemporary and culturally sensitive perspectives, our study sheds light on the effectiveness of restoration thinning treatments, emphasizing the delicate balance between ecological resilience and cultural preservation for the Navajo Nation.

IntroductionAlthough schizophrenia is associated with a broad range of symptoms including hallucinations, delusions, and reduced motivation, measures of cognitive dysfunction, including cognitive flexibility and executive function, are the strongest predictors of functional outcomes. Antipsychotic medications are useful for reducing psychotic symptoms, but they are ineffective at improving cognitive deficits. Despite extensive investment by industry, the transition from preclinical to clinical trials has not been successful for developing precognitive medications for individuals with schizophrenia. Here, we describe the optimisation of a novel dynamic strategy shifting task (DSST) using standard operant chambers to investigate the optimal stimuli required to limit the extensive training times required in previous tasks.MethodsWe determined that optimal learning by male and female Sprague Dawley rats for the flexibility task incorporated dynamic strategy shifts between spatial rules, such as following a visual cue or responding at one location, and non-spatial rules, such as responding to a central visual or auditory cue. A minimum of 6 correct consecutive responses were required to make a within-session change in the behavioural strategies. As a proof of concept, we trained and tested 84 Sprague Dawley rats on the DSST, and then assessed their cognitive flexibility using a within-subject design after an acute dose of ketamine (0, 3, 10 mg/kg). Rats made fewer premature and more perseverant responses to initiate a trial following ketamine. The effects of ketamine on trials to criterion was dependent on the rule.ResultsKetamine induced a significant improvement on the reversal of a non-spatial visual discrimination rule. There was no significant effect of ketamine on the spatial visual or response discrimination rules.DiscussionThe DSST is a novel assay for studying distinct forms of cognitive flexibility and offers a rapid and adaptable means of assessing the ability to shift between increasingly challenging rule conditions. The DSST has potential utility in advancing our understanding of cognitive processes and the underlying neurobiological mechanisms related to flexibility in neuropsychiatric and neurological conditions where executive dysfunctions occur.>

Abstract The radius of maximum wind (RMW) defines the location of the maximum winds in a tropical cyclone and is critical to understanding intensity change as well as hazard impacts. A comparison between the Hurricane Analysis and Forecast System (HAFS) models and two statistical models based off the National Hurricane Center official forecast is conducted relative to a new baseline climatology to better understand whether models have skill in forecasting the RMW of North Atlantic tropical cyclones. On average, the HAFS models are less skillful than the climatology and persistence baseline and two statistically derived RMW estimates. The performance of the HAFS models is dependent on intensity with better skill for stronger tropical cyclones compared to weaker tropical cyclones. To further improve guidance of tropical cyclone hazards, more work needs to be done to improve forecasts of tropical cyclone structure.

Objective Older adults with rheumatoid arthritis (RA) account for up to one‐third of the RA population and are less likely to receive optimal treatment. For the subgroup of older adults with late‐onset RA (LORA), who experience more symptomatic and progressive disease, suboptimal treatment could be more consequential than the general population who age with RA. We evaluated use of disease‐modifying antirheumatic drugs (DMARDs) in older adults with a new diagnosis of LORA. Methods In this retrospective observational study, we identified adults 66 years of age or older with a new diagnosis of LORA using Medicare data from 2008 to 2017. Information on baseline patient characteristics and DMARD initiation during the first 12 months after LORA diagnosis were collected. We also assessed concomitant use of glucocorticoids (GCs). Results We identified 33,373 older adults with new diagnosis of LORA. Average age at LORA diagnosis was 76.7 (SD 7.6); 75.4% were female, 76.9% were White, and 35.6% had low‐income subsidy (LIS). Less than one‐third were initiated on a DMARD (28.9%). In multivariable analyses, DMARD initiation was associated with younger age, fewer comorbidities, and absence of LIS status. Concomitant long‐term (>3 months) GC use was higher among those on any DMARD (44.3%) compared with those without (15.2%). Conclusions DMARD initiation after new diagnosis of LORA is low despite current clinical practice guidelines recommending early aggressive initiation of treatment. Long‐term GC use is common among those on any DMARDs, raising concern for suboptimal DMARD use. Further studies are needed to understand drivers of DMARD use in older adults.

Abstract Background Bladder and urinary tract cancers account for approximately 21,000 new diagnoses and 5,000 deaths annually in the UK. Approximately 90% are transitional cell carcinomas where advanced disease is treated with platinum based chemotherapy and PD-1/PD-L1 directed immunotherapy. Urinary tract squamous cell carcinoma (UTSCC) accounts for about 5% of urinary tract cancers overall making this a rare disease. We have yet to establish definitive systemic treatment options for advanced UTSCC. Preliminary translational data, from UTSCC patient tumour samples, indicate high PD-L1 expression and tumour infiltrating lymphocytes in a proportion of cases. Both of these features are associated with differential gene expression consistent with a tumour/immune microenvironment predicted to be susceptible to immune checkpoint directed immunotherapy which we will evaluate in the AURORA trial. Methods AURORA is a single arm, open-label, multicentre,UK phase II clinical trial. 33 patients will be recruited from UK secondary care sites. Patients with UTSCC, suitable for treatment with palliative intent, will receive atezolizumab PD-L1 directed immunotherapy (IV infusion, 1680 mg, every 28 days) for one year if tolerated. Response assessment, by cross sectional imaging will occur every 12 weeks. AURORA uses a Simon’s 2-stage optimal design with best overall objective response rate (ORR, by RECIST v1.1) at a minimum of 12 weeks from commencing treatment as the primary endpoint. Secondary endpoints will include overall survival, progression-free survival, duration of response, magnitude of response using waterfall plots of target lesion measurements, quality of life using the EORTC QLQ-C30 tool, safety and tolerability (CTCAE v5) and evaluation of potential biomarkers of treatment response including PD-L1 expression. Archival tumour samples and blood samples will be collected for translational analyses. Discussion If this trial shows atezolizumab to be safe and effective it may lead to a future late phase randomised controlled trial in UTSCC. Ultimately, we hope to provide a new option for treatment for such patients. Trial registrations EudraCT Number: 2021-001995-32 (issued 8th September 2021); ISRCTN83474167 (registered 11 May 2022); NCT05038657 (issued 9th September 2021).

Background: Selective deprivation of glutamine has been shown to accelerate the generation of reactive oxygen species (ROS) and to impair the activity of a specific pentose phosphate pathway (PPP) located within the endoplasmic reticulum (ER). The consequent oxidative damage suggests that glucose flux through this reticular pathway might contribute to the redox stress of breast cancer cells. We thus evaluated whether this response is reproduced when the glutamine shortage is coupled with the glucose deprivation. Methods: Cancer growth, metabolic plasticity and redox status were evaluated under saturating conditions and after 48 h starvation (glucose 2.5 mM, glutamine 0.5 mM). The Seahorse technology was used to estimate adenosine triphosphate (ATP)-linked and ATP-independent oxygen consumption rate (OCR) as well as proton efflux rate (PER). 18F-fluoro-deoxy-glucose (FDG) uptake was evaluated through the LigandTracer device. Proliferation rate was estimated by the carboxyfluorescein-diacetate-succinimidyl ester (CFSE) staining, while cell viability by the propidium iodide exclusion assay. Results: Starvation reduced the proliferation rate of MCF-7 cells without affecting their viability. It also decreased lactate release and PER. Overall OCR was left unchanged although ATP-synthase dependent fraction was increased under nutrient shortage. Glutaminolysis inhibition selectively impaired the ATP-independent and the oligomycin-sensitive OCR in control and starved cultures, respectively. The combined nutrient shortage decreased the cytosolic and mitochondrial markers of redox stress. It also left unchanged the expression of the reticular unfolded protein marker GRP78. By contrast, starvation decreased the expression of hexose-6P-dehydrogenase (H6PD) thus decreasing the glucose flux through the ER-PPP as documented by the profound impairment in the uptake rate of FDG. Conclusions: When combined with glucose deprivation, glutamine shortage does not elicit the expected enhancement of ROS generation in the studied breast cancer cell line. Combined with the decreased activity of ER-PPP, this observation suggests that glutamine interferes with the reticular glucose metabolism to regulate the cell redox balance.

The use of organic sources presents itself as a viable alternative to mitigate the excessive reliance on chemical fertilizers in agricultural practices. However, in the realm of pineapple cultivation, research exploring the synergy between chemical and organic fertilizers remains scarce. In this context, the objective of this research was to evaluate the impact of the combination of chemical and organic fertilizers on the growth and yield of the MD-2 pineapple cultivar under two shade net conditions (installed 45 and 250 days after planting). The experiment was conducted in a split-plot design, with the main plot being the shade net conditions and the sub-plots the five fertilization treatments, which were applied 18 times via drip irrigation (control, 100% chemical fertilization, 50% reduced chemical fertilization, organic fertilization, and a combination of 50% chemical fertilization with organic fertilization). The results showed that the early installation of shade netting 45 days after planting decreases the growth and yield of pineapple; thus, the use of shade netting at this age is not recommended. Regarding fertilization, the combination of 50% chemical fertilization with organic fertilization showed similar growth and yield values compared to 100% conventional chemical fertilization under both shade net conditions. Furthermore, this combination presented similar nitrate and potassium values in the plant and did not negatively affect malic acid content. Therefore, the use of organic fertilizers in pineapple cultivation is a promising strategy to reduce the excessive use of chemical fertilizers, and it could also improve soil fertility.

Abstract Background Androgen deprivation therapy (ADT) is prescribed to almost half of all men diagnosed with prostate cancer. Although ADT is effective treatment, with virtually all men with advanced disease showing initial clinical response, it is associated with troublesome side effects including hot flushes and night sweats (HFNS). HFNS can be both frequent and severe and can have a significant impact on quality of life (QoL). They can occasionally be so debilitating that patients stop ADT altogether, despite the increased risk of disease relapse or death. Previous research has found that guided self-help cognitive behavioural therapy (CBT) can be effective in reducing HFNS due to ADT when delivered by a clinical psychologist. MANCAN2 aims test whether we can train the existing NHS Prostate Cancer Nurse Specialist (CNS) team to deliver guided self-help CBT and whether it is effective in reducing the impact of HFNS in men undergoing ADT. Methods MANCAN2 is a phase III multicentre randomised controlled trial and process evaluation. Between 144 and 196 men with prostate cancer who are currently receiving ADT and are experiencing problematic HFNS will be individually randomised in a 1:1 ratio in groups of 6–8 participants to either treatment as usual (TAU) or participation in the guided self-help CBT intervention plus TAU. A process evaluation using the normalisation process theory (NPT) framework will be conducted, to understand the CNS team’s experiences of delivering the intervention and to establish the key influencers to its implementation as a routine practice service. Fidelity of implementation of the intervention will be conducted by expert assessment. The cost-effectiveness of the intervention and participant adherence to the trial intervention will also be assessed. Discussion MANCAN2 will advance the program of work already conducted in development of management strategies for HFNS. This research will determine whether the severity of ADT-induced HFNS in men with prostate cancer can be reduced by a guided self-help CBT intervention, delivered by the existing NHS prostate cancer CNS team, within a multicentre study. The emphasis on this existing team, if successful, should facilitate translation through to implementation in routine practice. Trial registration ISRCTN reference 58720120 . Registered 13 December 2022

IntroductionUniversity dropouts are a problem in the Chilean higher education system, which causes psychosocial and economic damage and requires further studies to understand it comprehensively. This study aimed to determine the psychosocial variables influencing the risk of dropping out of the higher education system in a sample of Chilean university students post-pandemic.MethodsWith a sample of 655 students from the Chilean higher education system and with a cross-sectional study design taken in November 2022, a questionnaire was applied with sociodemographic and other variables of interest, the Depression, Anxiety and Stress Scale DASS-21, the EAC-19 Coronavirus Affect Scale, the ECE Emotional Exhaustion Scale; the Okasha Suicide Scale, and the Insomnia Severity Index (ISI). We performed descriptive, bivariate, and multiple logistic regression analyses through SPSS version 25. Variables with a value of p

Abstract Variational autoencoders are unsupervised learning models with generative capabilities, when applied to protein data, they classify sequences by phylogeny and generate de novo sequences which preserve statistical properties of protein composition. While previous studies focus on clustering and generative features, here, we evaluate the underlying latent manifold in which sequence information is embedded. To investigate properties of the latent manifold, we utilize direct coupling analysis and a Potts Hamiltonian model to construct a latent generative landscape. We showcase how this landscape captures phylogenetic groupings, functional and fitness properties of several systems including Globins, β-lactamases, ion channels, and transcription factors. We provide support on how the landscape helps us understand the effects of sequence variability observed in experimental data and provides insights on directed and natural protein evolution. We propose that combining generative properties and functional predictive power of variational autoencoders and coevolutionary analysis could be beneficial in applications for protein engineering and design.

This article explores Maurice Blondel’s (1861–1949) later notion of the “cycloid” of thought, particularly as this helps us to understand his earlier work L’Action (1893). The aim is to demonstrate how Blondel incorporates aspects of the Christian faith, particularly the Eucharist, into his philosophy without abrogating his “method of immanence”. In particular, the article shows how Blondel saw attention to the Christian spirit as essential to the development of a metaphysics that attends both to finite actions and to the action of God, actus purus.

Abstract Tropical weather phenomena—including tropical cyclones (TCs) and equatorial waves—are influenced by planetary‐to‐convective‐scale processes; yet, existing data sets and tools can only capture a subset of those processes. This study introduces a convection‐permitting aquaplanet simulation that can be used as a laboratory to study TCs, equatorial waves, and their interactions. The simulation was produced with the Model for Prediction Across Scales‐Atmosphere (MPAS‐A) using a variable resolution mesh with convection‐permitting resolution (i.e., 3‐km cell spacing) between 10°S and 30°N. The underlying sea‐surface temperature is given by a zonally symmetric profile with a peak at 10°N, which allows for the formation of TCs. A comparison between the simulation and satellite, reanalysis, and airborne dropsonde data is presented to determine the realism of the simulated phenomena. The simulation captures a realistic TC intensity distribution, including major hurricanes, but their lifetime maximum intensities may be limited by the stronger vertical wind shear in the simulation compared to the observed tropical Pacific region. The simulation also captures convectively coupled equatorial waves, including Kelvin waves and easterly waves. Despite the idealization of the aquaplanet setup, the simulated three‐dimensional structure of both groups of waves is consistent with their observed structure as deduced from satellite and reanalysis data. Easterly waves, however, have peak rotation and meridional winds at a slightly higher altitude than in the reanalysis. Future studies may use this simulation to understand how convectively coupled equatorial waves influence the multi‐scale processes leading to tropical cyclogenesis.

Introduction: emotional exhaustion among trainee teachers is a relevant topic since it could have repercussions regarding the lives of their future pupils. Our objective was to determine the degree of trainee teachers’ emotional exhaustion and associated variables during the COVID-19 pandemic. Methods: the design was cross-sectional and descriptive. Questionnaires with sociodemographic variables, perceptions of mental health, and the Emotional Exhaustion Scale (ECE) (α = 0.890; ω = 0.893) validated for the Chilean context were answered by 204 trainee teachers. The results were analyzed using SPSS software version 25 and the Emotional Exhaustion Interpretation Table (EES-Int). Results: the results show that 92.2% of the trainee teachers presented a worsening in their mental health, stress (66.2%), irritability (38.2%), anxiety (37.7%), and depressive symptoms (32.8%). Online classes (73.04%) and the pandemic (67.6%) were the main influencing factors. Education students who perceived their mental health had worsened became 6.63 times more likely to develop emotional exhaustion [AOR = 6.63; 95% CI: 1.78, 24.69]. In addition, education students with a high perception of academic stress were 7.45 more likely to develop emotional exhaustion [AOR = 7.45; 95% CI: 1.98, 28.09]. Conclusion: we can conclude that trainee teachers have high levels of emotional exhaustion and their perception of their mental health and the academic stress they are being subjected to during the COVID-19 pandemic may lead them to present symptoms of frequent or permanent problems with concentration, attention, recall of information, dissatisfaction with their performance, and frequent learning difficulties. From the affective dimension, they present frequent or permanent anxiety, restlessness, irritability, indifference, low mood, and psychomatization. From the socio-interactional dimension, they present frequent or permanent social withdrawal, interpersonal problems, problems at work or school, and family and relationship problems. Increasing the sample to delve into emotional exhaustion by subject area is necessary. For future studies, research should be conducted on the causes of emotional exhaustion by subject area and the coping strategies of trainee teachers to understand differences and provide input on emotional support in practice.

Abstract Patients with antiphospholipid syndrome (APS) typically require lifelong warfarin anticoagulation following a thrombotic event due to a significant risk of recurrent thrombosis. Point of care testing (POCT) to monitor INR is discouraged in patients with APS as interactions between antiphospholipid antibodies and thromboplastin used for INR testing may influence results. Review of INR testing in 36 APS patients showed 87.2% of paired POCT and venous INRs (n = 94) having acceptable variation (≤0.5 difference), and high correlation (r = 0.9) excluding INRs ≥4.8. Six‐month TTR was comparable for APS patients using POCT (57.1% ± 24.8%) to those using venous INR monitoring (59.2% ± 23.2%) (p = 0.66). These results support POCT management of APS but requires further study.

Objectives Selective prehospital cervical spine motion restriction (C-SMR) following blunt trauma has increasingly been used by emergency medical service (EMS) providers. We determined rates of prehospital C-SMR and concomitant radiographic injury patterns.Methods A retrospective trauma registry and chart review was conducted for all adult blunt trauma patients who were transported by EMS and hospitalized with radiographic cervical spine injuries from 2011 to 2019 at a level 1 trauma center.Results Of 658 admitted blunt trauma patients with confirmed cervical spine injury by imaging, 117 (17.8%) did not receive prehospital C-SMR. Patients without prehospital C-SMR were significantly older (76 vs 54 years), more often had low fall as mechanism of injury (59.8% vs 15.9%) and had lower Injury Severity Score (10 vs 17). Patients without C-SMR (Non-SMR) experienced the full array of cervical spine injury types and locations. While the non-SMR patients most often had dens fractures,C-SMR patients most often had C7 fractures; frequencies of fractures at the remaining vertebral levels were comparable. On MRI, cervical spinal cord (8.5% vs 19.6%) and ligamentous injuries (5.1% vs 12.6%) occurred less often in non-SMR patients. Approximately 8.5% of non-SMR patients and 20% of C-SMR patients required cervical spine surgery.Conclusion Patients without prehospital C-SMR demonstrate a broad array of cervical spine injuries. While the rates of certain cervical injuries are lower in prehospital non-SMR patients, they are not insignificant.Level of evidence Level III.

This practice-based paper explores the methods of answering the question: what is our collective body? This article offers a case study of collaborative research and seeks to enact a collective body as a means of transgressing and occupying individuated neoliberal spaces of higher education. Understanding the processes through which knowledge is collectively built highlights the in-becoming nature of practice-based research and the enabling forces of this inquiry. The methods enacted access a particular rendering of how we understand ourselves as a collective; we answer the question through doing together. The ways we encounter the collective enable understanding around the shifting boundaries of the individual–collective connection, made palpable by a string. Through playful forms of dissent, such as embodied, remembered, and writing encounters, enable connections with others and inspire a refocusing of our individual practices.

Liquid chromatography–high-resolution mass spectrometry (LC/HRMS) is a powerful tool for detecting chemicals that are present in low concentrations [...]

Abstract Background Bispectral index (BIS) monitoring uses electroencephalographic data as an indicator of patients’ consciousness level. This technology might be a useful adjunct to clinical observation when titrating sedative medications for palliative care patients. However, the use of BIS in palliative care generally, and in the UK in particular, is under-researched. A key area is this technology’s acceptability for palliative care service users. Ahead of trialling BIS in practice, and in order to ascertain whether such a trial would be reasonable, we conducted a study to explore UK palliative care patients’ and relatives’ perceptions of the technology, including whether they thought its use in palliative care practice would be acceptable. Methods A qualitative exploration was undertaken. Participants were recruited through a UK hospice. Focus groups and semi-structured interviews were conducted with separate groups of palliative care patients, relatives of current patients, and bereaved relatives. We explored their views on acceptability of using BIS with palliative care patients, and analysed their responses following the five key stages of the Framework method. Results We recruited 25 participants. There were ten current hospice patients in three focus groups, four relatives of current patients in one focus group and one individual interview, and eleven bereaved relatives in three focus groups and two individual interviews. Our study participants considered BIS acceptable for monitoring palliative care patients’ consciousness levels, and that it might be of use in end-of-life care, provided that it was additional to (rather than a replacement of) usual care, and patients and/or family members were involved in decisions about its use. Participants also noted that BIS, while possibly obtrusive, is not invasive, with some seeing it as equivalent to wearable technological devices such as activity watches. Conclusions Participants considered BIS technology might be of benefit to palliative care as a non-intrusive means of assisting clinical assessment and decision-making at the end of life, and concluded that it would therefore be acceptable to trial the technology with patients.

BackgroundMental health among university students is a public health problem in Chile, understanding that this population is susceptible to mental disorders.ObjectiveThe present study aimed to determine the prevalence and variables influencing depression, anxiety, and stress in Chilean university students.MethodA representative sample (n = 1,062) of Chilean university students and a cross-sectional study design were used. Bivariate analysis and multiple logistic regression were performed to identify risk factors associated with symptomatology. They were analyzed using descriptive statistics. A questionnaire with sociodemographic variables was applied in November 2022, in addition to the depression anxiety stress scale (DASS-21), instruments with excellent reliability in this population (α = 0.955; ω = 0.956). On the other hand, the Questionnaire of Problematic Alcohol and Drug Consumption (DEP-ADO) was applied. A descriptive analysis was performed, followed by bivariate analysis and multiple logistic regression using SPSS version 25. The variables showed a value of p

More than 50 years have passed since Nobel laureate Cristian de Duve described for the first time the presence of tiny subcellular compartments filled with hydrolytic enzymes: the lysosome. For a long time, lysosomes were deemed simple waste bags exerting a plethora of hydrolytic activities involved in the recycling of biopolymers, and lysosomal genes were considered to just be simple housekeeping genes, transcribed in a constitutive fashion. However, lysosomes are emerging as multifunctional signalling hubs involved in multiple aspects of cell biology, both under homeostatic and pathological conditions. Lysosomes are involved in the regulation of cell metabolism through the mTOR/TFEB axis. They are also key players in the regulation and onset of the immune response. Furthermore, it is becoming clear that lysosomal hydrolases can regulate several biological processes outside of the lysosome. They are also implicated in a complex communication network among subcellular compartments that involves intimate organelle‐to‐organelle contacts. Furthermore, lysosomal dysfunction is nowadays accepted as the causative event behind several human pathologies: low frequency inherited diseases, cancer, or neurodegenerative, metabolic, inflammatory, and autoimmune diseases. Recent advances in our knowledge of the complex biology of lysosomes have established them as promising therapeutic targets for the treatment of different pathologies. Although recent discoveries have started to highlight that lysosomes are controlled by a complex web of regulatory networks, which in some cases seem to be cell‐ and stimuli‐dependent, to harness the full potential of lysosomes as therapeutic targets, we need a deeper understanding of the little‐known signalling pathways regulating this subcellular compartment and its functions.

The main objective of this study was to estimate the psychometric properties of the Emotional Fatigue Scale (ECE) in a sample of 1308 Chilean university students and confirm the unifactorial structure of the scale. Exploratory and confirmatory factor analyses were carried out. The ECE assessment had an internal consistency of 0.893 (Cronbach’s Alpha). An exploratory factor analysis with Varimax rotation and a confirmatory analysis were performed, obtaining the factor that explains 52.3% of the variance. The results indicated that the ECE has adequate psychometric properties for use with higher education students in Chile. The ECE scale has good psychometric properties to be applied in the Chilean university context. Its usage may be very relevant to contribute to higher education institutions to emphasize students’ mental health and prevent possible severe pathologies in future professionals. It is suggested to use the ECE scale together with the EES-Int, which is the only interpretation table for this instrument.

Goal: To achieve high-quality comprehensive feature extraction from physiological signals that enables precise physiological parameter estimation despite evolving waveform morphologies. Methods: We propose Boosted-SpringDTW, a probabilistic framework that leverages dynamic time warping (DTW) and minimal domain-specific heuristics to simultaneously segment physiological signals and identify fiducial points that represent cardiac events. An automated dynamic template adapts to evolving waveform morphologies. We validate Boosted-SpringDTW performance with a benchmark PPG dataset whose morphologies include subject- and respiratory-induced variation. Results: Boosted-SpringDTW achieves precision, recall, and F1-scores over 0.96 for identifying fiducial points and mean absolute error values less than 11.41 milliseconds when estimating IBI. Conclusion: Boosted-SpringDTW improves F1-Scores compared to two baseline feature extraction algorithms by 35% on average for fiducial point identification and mean percent difference by 16% on average for IBI estimation. Significance: Precise hemodynamic parameter estimation with wearable devices enables continuous health monitoring throughout a patients’ daily life.

Abstract Arboreal camera trapping is a burgeoning method providing a novel and effective technique to answer research questions across a variety of ecosystems, and it has the capacity to improve our understanding of a wide range of taxa. However, while terrestrial camera trapping has received much attention, there is little guidance for dealing with the unique challenges of working in the arboreal realm. Our review draws on the expertise of researchers from six continents and the broader literature to investigate the advantages and disadvantages of arboreal camera trapping, and challenges to consider when using this technology. We also include mini‐guides with detailed information on the current arboreal camera trap literature, mounts used to install arboreal cameras, tree climbing pointers and safety tips, methods for deploying cameras without climbing, and tips for managing interference with camera function. We find that arboreal camera traps have been most commonly used in the study of mammals in forests; however, there is potential for this method to be applied to a broad range of habitats including urban areas, and taxa such as birds, amphibians, invertebrates, and plants. Methods in arboreal camera trapping could be improved by developing a greater understanding of the factors affecting detection of species. The most common challenges of arboreal camera trapping are camera placement and camera site access. These can be overcome by understanding correct camera orientation, managing potential sources of interference in front of cameras, utilizing appropriate cameras mounts and training researchers properly. Given the benefits and opportunities presented by arboreal camera trapping, it is likely to become an ever‐more popular method of studying arboreal species and systems. The information synthesized in this review provides guidance for future studies to help direct more reliable and robust ecological inferences from arboreal camera trapping.

Racial and ethnic minority communities have been disproportionately affected by COVID-19, but the uptake of COVID-19 mitigation strategies like vaccination and testing have been slower in these populations. With the continued spread of COVID-19 while in-person learning is a priority, school-aged youth and their caregivers must make health-related decisions daily to ensure health at school. It is critical to understand factors associated with COVID-related health decisions such as vaccination, testing, and other health behaviors (e.g., wearing masks, hand washing). Community-engaged campaigns are necessary to overcome barriers to these health behaviors and promote health equity. The aim of this study was to examine COVID-19-related concerns and influences on health decisions in middle and high schools serving primarily racial and ethnic minority, low-income families. Seven focus groups were conducted with school staff, parents, and students (aged 16 years and older). Qualitative data were analyzed using a general inductive approach. Factors related to COVID-19 concerns and health decisions centered on (1) vaccine hesitancy, (2) testing hesitancy, (3) developmental stage (i.e., ability to engage in health behaviors based on developmental factors like age), (4) cultural and family traditions and beliefs, (5) compatibility of policies and places with recommended health behaviors, (6) reliability of information, and (7) perceived risk. We explore sub-themes in further detail. It is important to understand the community's level of concern and identify factors that influence COVID-19 medical decision making to better address disparities in COVID-19 testing and vaccination uptake.

BackgroundThe Collective Efficacy Scale Short-Form (CES-SF) is a short and reliable instrument that assesses collective efficacy in schools at a group level. Previous research has shown a two-factor structure considering the perception of the group competence about their teaching capabilities and task analysis that refers to the opportunities inherent to a specific task. However, there is no conclusive evidence that collective efficacy corresponds to a two-factor model or single-factor structure.MethodsA cross-sectional research was conducted on a 693 sample of teachers (Mage = 39.4; SD = 11.8) from schools in the 16 regions of Chile. They were assessed using the CES-SF, Personal Well-being Index, Social Well-Being Scale, and satisfaction with the school. Exploratory and confirmatory factor analyses were used to assess the construct validity of the CES-SF.ResultsThe CES-SF showed mixed results about its construct validity. Best fit has been found to retain two new factors (opportunities and challenges for collective efficacy) with eight items each, yielding a McDonald’s ω of 0.803. Convergent validity was also established.ConclusionThe psychometric results suggest that a two-factor structure for the CES-SF is a valid and reliable measure for this construct for Chilean teachers. However, collective efficacy might not strongly relate to subjective wellbeing but to school-context variables.

Obesity is a pandemic associated with lifestyles changes. These include excess intake of obesogenic foods and decreased physical activity. Brain areas, like the lateral hypothalamus (LH), ventral tegmental area (VTA), and nucleus accumbens (NAcc) have been linked in both homeostatic and hedonic control of feeding in experimental models of diet-induced obesity. Interestingly, these control systems are regulated by the lateral septum (LS), a relay of γ-aminobutyric (GABA) acid neurons (GABAergic neurons) that inhibit the LH and GABAergic interneurons of the VTA. Furthermore, the LS has a diverse receptor population for neurotransmitters and neuropeptides such as dopamine, glutamate, GABA and corticotropin-releasing factor (CRF), among others. Particularly, CRF a key player in the stress response, has been related to the development of overweight and obesity. Moreover, evidence shows that LS neurons neurophysiologically regulate reward and stress, although there is little evidence of LS taking part in homeostatic and hedonic feeding. In this review, we discuss the evidence that supports the role of LS and CRF on feeding, and how alterations in this system contribute to weight gain obesity.