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Conservation of coastal biodiversity and associated ecosystem services requires protection and management for attributes of coastal wildness, which we define to include physical and ecological intactness and connectivity, native species and habitat diversity, and limited human disturbance. Coastal wildness is threatened by high demand for access to and development of coastal margins; sea level rise exacerbates this threat. As a case study, California (USA), a biodiversity hotspot, has a network of marine and terrestrial protected areas along the coast and strong coastal policy. While 35% of California’s coast has wildness attributes, only 9% of California’s coast is characterized as wild and also protected on both land and in the adjacent waters. A multi-tiered approach is needed to incorporate wild coast attributes into conservation planning and protection of coastal areas. A coastal wildness designation is needed, as well as policies that manage for wildness attributes in existing protected areas.

The increasing occurrence of catastrophic wildfire across the globe threatens public health, community safety, ecosystem functioning, and biodiversity resilience. Wildfire risk is closely connected to shifting climatic trends and their impacts on fuel availability and flammability. Although previous research has explored the connection between meteorological conditions and wildfire probabilities, there remains a substantial gap in understanding the influence of hydrologic drivers, such as groundwater recharge, on wildfire dynamics. Both short- and long-term variations in these variables are crucial in shaping fuel conditions, and significant changes can create environments more prone to severe wildfires. This study focuses on Santa Barbara County to examine the connection between wildfire probability and various environmental factors, including meteorological and hydrological data from 1994 to 2021, topography, vegetation, and proximity to road. Using a random forest (RF) machine learning model and fine-scale data (270 m resolution) we achieved high predictive accuracy in identifying wildfire probability. Our findings confirm the important roles of short-term meteorological conditions, such as mean precipitation 12 months and relative humidity 1 month before a wildfire event, in predicting wildfire occurrence. In addition, our results emphasize the critical contribution of long-term hydrological components, such as mean deviation from the historical normal in actual evapotranspiration and recharge in the years preceding the fire, in influencing wildfire probability. Partial dependence plots from our RF model revealed that both positive and negative deviations of these hydrological variables can increase the likelihood of wildfire by controlling fuel water availability and productivity. These findings are particularly relevant given the increasing extreme weather patterns in southern California, significantly affecting water availability and fuel conditions. This study provides valuable insights into the complex interactions between wildfire occurrence and hydrometeorological conditions. Additionally, the resulting wildfire probability map, can aid in identifying high-risk areas, contributing to enhanced mitigation planning and prevention strategies.

Abstract Background Improved methodology to measure acute phase proteins and determination of lipoprotein particle‐size distribution (PSD) could be clinically useful in dogs with systemic inflammatory processes. Objectives Evaluate an immunoturbidometric assay for serum amyloid A (SAA) and lipoprotein PSD in dogs with sepsis, nonseptic systemic inflammation, and in healthy controls. Correlate dyslipidemic changes with SAA and C‐reactive protein (CRP) concentrations. Animals Twenty‐five dogs with sepsis, 15 dogs with nonseptic systemic inflammation, and 22 healthy controls. Methods Prospective, case‐control study. Variables included SAA, CRP, and electrophoretic subfractionation of high‐ and low‐density lipoproteins (HDL, LDL). Continuous variables were compared using ANOVA or Kruskal‐Wallis tests with linear regression or Spearman's rank correlation used to assess relationships between variables. Results Median SAA and CRP concentrations were greater in dogs with sepsis (SAA 460 mg/L, interquartile range [IQR] 886 mg/L; CRP 133.2 mg/L, IQR 91.6 mg/L) and nonseptic inflammation (SAA 201 mg/L, IQR 436 mg/L; CRP 91.1 mg/L, IQR 88.6 mg/L) compared to healthy dogs (SAA 0.0 mg/L, IQR 0.0 mg/L; CRP 4.9 mg/L, IQR 0.0 mg/L) P 677.5 mg/L SAA was 43.2% sensitive and 92.3% specific for sepsis. Low‐density lipoprotein was higher in dogs with sepsis 29.6%, (mean, SD 14.6) compared to 14.4% (mean, SD 5.6) of all lipoproteins in healthy controls (P = .005). High‐density lipoprotein was not associated with CRP but was negatively correlated with SAA (rs −0.47, P

Ecological land classifications serve diverse purposes including sample stratification, inventory, impact assessment and environmental planning. While popular, data-driven classification approaches can require large training samples, frequently with limited robustness to rapid environmental change. We evaluate the potential to derive useful, durable ecological land classifications from a synthesis of multi-decadal satellite imagery and geospatial environmental data. Using random forests and multivariate regression trees, we analyze 1982–2000 Landsat Thematic Mapper (L45) and 2013–2020 Harmonized Landsat Sentinel (HLS) imagery to develop and then test the predictive skill of an ecological land classification for monitoring Mediterranean-climate oak woodlands at the recently established Jack and Laura Dangermond Preserve (JLDP) near Point Conception, California. Image pixels were processed using spectral and temporal mixture models. Temporal mixture model residual scores were highly correlated with oak canopy cover trends between 2012 and 2020 (r2 = 0.74, p << 0.001). The resulting topoclimatic-edaphic land classification effectively distinguished areas of systematically higher or lower oak dieback during 2012–2020 severe drought, with a fivefold difference in dieback rates between land classes. Our results highlight the largely untapped potential for developing predictive ecological land classifications from multi-decadal satellite imagery to guide scalable, ground-supported monitoring of rapid environmental change.

Summary: A clinical hereditary cancer population screening initiative, called Information is Power, began in North Alabama in 2015. After 4 years of the initiative, we were interested in exploring (1) the characteristics and motivations for patients who self-refer to population genetic testing, (2) how patients make decisions on testing, (3) what patients do with results, and (4) patient perceptions of benefits and limitations after undergoing population genetic testing. Patients who consented to research recontact at time of test ordering were sent an electronic survey with the option for a follow-up phone interview. Among the 2,918 eligible patients, 239 responded to the survey and 19 completed an interview. Survey and interview participants were highly educated information seekers motivated by learning more about their health. Those who were previously interested in hereditary cancer testing reported barriers were cost and insurance coverage, access to testing, and uncertainty how results could impact their health. Many participants (77%) communicated with family and friends about their decision to test and communicated about test results. Fewer participants (23%) discussed the decision to test with their healthcare providers; however, 58% of participants discussed their test results with a healthcare provider. Most people (96%) with negative results accurately recalled their results. In contrast, three out of 11 positive results for heterozygous MUTYH, PALB2, and BRCA2 reported receiving negative results. This study contributes to knowledge on population genetic testing and may guide other population genetic testing programs as they develop enrollment materials and educational materials and consider downstream needs of population genetic testing participants.

Abstract Background Genome sequencing (GS) of individuals without a medical indication, known as elective GS, is now available at a number of centers around the United States. Here we report the results of elective GS and pharmacogenetic panel testing in 52 individuals at a private genomics clinic in Alabama. Methods Individuals seeking elective genomic testing and pharmacogenetic testing were recruited through a private genomics clinic in Huntsville, AL. Individuals underwent clinical genome sequencing with a separate pharmacogenetic testing panel. Results Six participants (11.5%) had pathogenic or likely pathogenic variants that may explain one or more aspects of their medical history. Ten participants (19%) had variants that altered the risk of disease in the future, including two individuals with clonal hematopoiesis of indeterminate potential. Forty‐four participants (85%) were carriers of a recessive or X‐linked disorder. All individuals with pharmacogenetic testing had variants that affected current and/or future medications. Conclusion Our study highlights the importance of collecting detailed phenotype information to interpret results in elective GS.

Rationale: The hallmarks of allergic asthma are airway inflammation, obstruction, and remodeling. Airway remodeling may lead to irreversible airflow obstruction with increased morbidity and mortality. Despite advances in the treatment of asthma, the mechanisms underlying airway remodeling are still poorly understood. We reported that insulin-like growth factor (IGF) binding proteins (IGFBPs) contribute to extracellular matrix deposition in idiopathic pulmonary fibrosis; however, their contribution to airway remodeling in asthma has not been established.Objectives: We hypothesized that IGFBP-3 is overexpressed in asthma and contributes to airway remodeling.Methods: We evaluated levels of IGFBP-3 in tissues and bronchoalveolar lavage fluid from patients with asthma at baseline and 48 hours after allergen challenge, in reparative epithelium in an in vitro wounding assay, and in conditioned media from cytokine- and growth factor-stimulated primary epithelial cells.Measurements and Main Results: IGFBP-3 levels and distribution were evaluated by Western blot, ELISA, and immunofluorescence. IGFBP-3 is increased in vivo in the airway epithelium of patients with asthma compared with normal control subjects. The concentration of IGFBP-3 is increased in the bronchoalveolar lavage fluid of patients with asthma after allergen challenge, its levels are increased in reparative epithelium in an in vitro wounding assay and in the conditioned medium of primary airway epithelial cell cultures stimulated with IGF-I.Conclusions: Our results suggest that one mechanism of allergic airway remodeling is through the secretion of the profibrotic IGFBP-3 from IGF-I-stimulated airway epithelial cells during allergic inflammation. [ABSTRACT FROM AUTHOR]

Objective: To determine if very low birthweight children followed with ease differ in any perinatal or sociodemographic characteristics, or outcomes, compared with children followed with more difficulty. Methodology: Consecutive children of birthweight < 1000 g or with gestational ages < 28 weeks born in 1991 (n = 51) or of birthweight < 1500 g born in 1992 (n = 166) at the Royal Women’s Hospital, Melbourne, surviving to 5 years of age, were assessed at 5 years of age, corrected for prematurity. Those who attended on the first mutually agreed appointment without substantial reluctance were considered to have been followed with ease. The remainder were considered to have been followed with difficulty. Outcomes included impairments such as cerebral palsy, blindness, deafness, and low IQ. Children had a disability if they had any of cerebral palsy, blindness, deafness requiring amplification, or an IQ more than 1 SD below the mean. Results: Of the 217 survivors, 204 (94%) were assessed fully at 5 years of age. Of the 204 children assessed, 153 (75%) were followed with ease, and 51 (25%) with difficulty. Of data available in the perinatal period, significantly fewer children followed with more difficulty came from intact families, and more of their mothers had fewer than 12 years of schooling. More children followed with difficulty had a disability (41% compared with 19%), as they predominantly had lower IQ scores (mean difference in IQ – 12.7, 95% confidence interval – 18.0, – 7.4). The association between difficulty of assessment and both higher rates of disability and lower IQ scores remained after adjustment for significant perinatal and sociodemographic variables. Conclusions: Children followed with difficulty can partly be recognized on several sociodemographic characteristics in the perinatal period, and have substantially worse sensorineural outcomes than those followed with ease. In any longitudinal study, the more incomplete the follow up, the lower will be the rate of adverse sensorineural outcome. [ABSTRACT FROM AUTHOR]

Historical data play an important role in our understanding of environmental change and ecosystem dynamics. By lengthening the temporal scale of scientific inquiry, historical data reveal insights into the dynamic nature of ecosystems. However, most historical data has yet to make a full contribution, remaining “dark” and out of reach to the broader scientific community. This article responds to several calls stressing the importance of empirical historical materials and urges their preservation and accessibility. Despite the importance of historical data collections, few standards have emerged to integrate historical dark data into the larger digital data landscape. To encourage greater use of historical data across scientific disciplines it is vital to make data findable, accessible, interoperable, and reusable (e.g., the FAIR principles). In this paper we discuss the potential of historical dark data to contribute to the modern digital ecological data landscape. We do this by focusing on three cases from the University of California field and research stations and the groups that have worked to make historical dark data discoverable. Despite the common goal of maximizing the potential use of these data collections, each case and the methods employed are unique, and showcase varying levels of success in achieving the FAIR principles and shepherding historical data into the twenty-first century.

Unmanned aerial vehicles (UAVs) equipped with multispectral sensors present an opportunity to monitor vegetation with on-demand high spatial and temporal resolution. In this study we use multispectral imagery from quadcopter UAVs to monitor the progression of a water manipulation experiment on a common shrub, Baccharis pilularis (coyote brush) at the Blue Oak Ranch Reserve (BORR) ~20 km east of San Jose, California. We recorded multispectral imagery at several altitudes with nearly hourly intervals to explore the relationship between two common spectral indices, NDVI (normalized difference vegetation index) and NDRE (normalized difference red edge index), leaf water content and water potential as physiological metrics of plant water status, across a gradient of water deficit. An examination of the spatial and temporal thresholds at which water limitations were most detectable revealed that the best separation between levels of water deficit were at higher resolution (lower flying height), and in the morning (NDVI) and early morning (NDRE). We found that both measures were able to identify moisture deficit across treatments; however, NDVI was better able to distinguish between treatments than NDRE and was more positively correlated with field measurements of leaf water content. Finally, we explored how relationships between spectral indices and water status changed when the imagery was scaled to courser resolutions provided by satellite-based imagery (PlanetScope).We found that PlanetScope data was able to capture the overall trend in treatments but unable to capture subtle changes in water content. These kinds of experiments that evaluate the relationship between direct field measurements and UAV camera sensitivity are needed to enable translation of field-based physiology measurements to landscape or regional scales.

Individuals with schizophrenia tend to have high levels of cardiovascular disease and lower physical activity (PA) levels than the general population. Research is urgently required in developing evidence-based behavioral interventions for increasing PA in this population. One model that has been increasingly used to understand the mechanisms underlying PA is the Health Action Process Approach (HAPA). The purpose of this study was to adapt and pilot-test a HAPA-based inventory that reliably captures salient, modifiable PA determinants for individuals with schizophrenia. Initially, twelve outpatients with schizophrenia reviewed the inventory and provided verbal feedback regarding comprehension, item relevance, and potential new content. A content analysis framework was used to inform modifications to the inventory. The resultant inventory underwent a quantitative assessment of internal consistency and test-retest reliability. Twenty-five outpatients (Mage= 41.5 ± 13.5 years; 64% male) completed the inventory on two separate occasions, one week apart. All but two scales showed good internal consistency (Cronbach’s α=0.62–0.98) and test-retest correlations (rs = .21-.96). Preliminary assessment of criterion validity of the HAPA inventory showed significant, large-sized correlations between behavioural intentions and both affective outcome expectancies and task self-efficacy, and small-to-moderate correlations between self-reported minutes of moderate-to-vigorous PA and the volitional constructs of the HAPA model. These findings provide preliminary support for the reliability and validity of the first-ever inventory for examining theory-based predictors of moderate to vigorous PA intentions and behavior among individuals with schizophrenia. Further validation research with this inventory using an objective measure of PA behavior will provide additional support for its psychometric properties within the schizophrenia population.

Objective:  Non-Hispanic Black people (NHBP) have a three-fold higher rate of maternal mortality compared to other racial groups. Racial disparities in maternal morbidity are well-described; however, there are substantial differences in cultural, economic, and social determinants of health among racial groups. We thus sought to study the at-risk, non-Hispanic Black population as its own cohort to identify factors most associated with severe maternal morbidity (SMM)., Study Design:  This is a population-based retrospective case-control study of all live births in the United States between 2017 and 2019 using birth records obtained from the National Center for Health Statistics. The primary outcome for this study was to determine demographic, social, medical, and obstetric factors associated with maternal morbidity among NHBP who did and did not experience an SMM event. Multivariable logistic regression was used to estimate the adjusted odds ratio between each individual factor and the outcome of SMM among NHBP., Results:  Of the 1,624,744 NHBP who delivered between 2017 and 2019, 1.1% experienced an SMM event defined as a composite of blood product transfusion, eclamptic seizure, intensive care unit admission, unplanned hysterectomy, and uterine rupture. The rates of these individual SMM events per 10,000 deliveries were 50, 40, 20, 5, and 4 among NHBP, respectively. Among NHBP, factors associated in multivariable regression analysis with SMM in order of strength of association included cesarean delivery, earlier gestational age at delivery, preeclampsia, induction of labor, chronic hypertension, prior preterm birth, lower educational attainment, multifetal gestation, advanced maternal age, pregestational diabetes, and cigarette smoking. The population attributable fraction for cesarean delivery, preterm birth, and pregnancy-induced hypertensive disease for the outcome of SMM were 0.46, 0.23, and 0.07, respectively., Conclusion:  The three factors most associated with SMM among NHBP are potentially avoidable or modifiable by aggressive screening, prevention, and treatment of preeclampsia and preterm birth as well as reducing cesarean rates in this population., Key Points: · The rate of SMM in NHBP may be modifiable.. · NHBP have a three-fold higher rate of maternal mortality.. · Preeclampsia, preterm birth, and cesarean sections are most associated with maternal morbidity.., Competing Interests: None declared., (Thieme. All rights reserved.)

The purpose of this case report is to highlight both the feasibility and clinical utility of remote camera video head impulse testing (vHIT) in children <3 years. Five cases are described where remote camera vHIT was used to quantify ear specific semicircular function in children at risk for vestibular dysfunction. Remote camera vHIT is a helpful clinical tool for quantifying ear specific semicircular function in children between 6 and 31 months. Remote camera vHIT is feasible and provides ear specific information regarding semicircular canal function, which can be used to augment or validate the presence of vestibular dysfunction in children <3 years. Laryngoscope, 134:5201-5206, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Introduction:  Primary preventative medicine lacks a consensus on effective concussion prevention strategies for collegiate athletes. Cervical strength has been identified as a potential factor in concussion risk reduction. This study evaluates the impact of a commercially available, portable cervical muscle stretching and strengthening device, NeckX®, on cervical strength, range of motion (ROM), and concussion incidence in collegiate athletes participating in high-concussion-risk sports., Methods:  A single-arm prospective cohort study was conducted with 162 collegiate athletes from various sports. Participants underwent a 12-week neck exercise protocol using the NeckX® device. Clinical data, including neck strength and ROM, were collected at weeks 0, 6, and 12. Concussion incidence was self-reported by participants and cross-referenced with records from the athletic department. Data were analyzed for significant neck strength and ROM changes throughout the 12-week study. A two-way analysis of variance multiple comparisons with the Tukey-Kramer significant difference test was utilized, using the Holm-Sidak method, with an alpha of 0.05., Results:  All athletic teams experienced a significant increase in cervical strength during the 12-week intervention (α = 0.05, p < 0.05). Increases in cervical flexion and extension force were most consistent between teams. Cervical ROM increased significantly in male and female soccer players (α = 0.05, p < 0.05). The overall incidence of head and neck injuries, including concussions, was reduced to 6.60% during the study period, the lowest recorded value in the university's athletic department history., Conclusion:  The use of the NeckX® device for 12 weeks was effective in enhancing pericervical muscle strength and ROM while reducing concussion incidence in collegiate athletes participating in high-concussion-risk sports. Interestingly, the positive outcomes were consistent for both males and females, indicating the universal advantages of neck training among collegiate athletes. These findings support existing research on the benefits of cervical strengthening exercises for reducing concussions in collegiate athletes and highlight the convenience and affordability of using this device., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Mercyhurst University Institutional Review Board issued approval 00018003. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Intellectual property info: Devices used in this research include the NeckX® device (NeckX® LLC, Aspen, CO), Activ5® dynamometer (Activbody, Inc., San Diego, CA), and Halo digital goniometer (Halo Medical Devices, LLC, Sydney, Australia). No financial compensation was provided for the use of any device. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Klein et al.)

Background: Chagas disease (CD) is a parasitic disease that affects ∼300 000 people living in the United States. CD leads to cardiac and/or gastrointestinal disease in up to 30% of untreated people. However, end-organ damage can be prevented with early diagnosis and antiparasitic therapy., Methods: We reviewed electronic health records of patients who underwent testing for CD at four hospital systems in California and Texas between 2016 and 2020. Descriptive analyses were performed as a needs assessment for improving CD diagnosis., Results: In total, 470 patients were tested for CD. Cardiac indications made up more than half (60%) of all testing, and the most frequently cited cardiac condition was heart failure. Fewer than 1% of tests were ordered by obstetric and gynecologic services. Fewer than half (47%) of patients had confirmatory testing performed at the Centers for Disease Control and Prevention., Discussion: Four major hospitals systems in California and Texas demonstrated low overall rates of CD diagnostic testing, testing primarily among older patients with end-organ damage, and incomplete confirmatory testing. This suggests missed opportunities to diagnose CD in at-risk individuals early in the course of infection when antiparasitic treatment can reduce the risk of disease progression and prevent vertical transmission., Competing Interests: Potential conflicts of interest. C. B. receives royalties from Wolters Kluwer publishers for UpToDate topics on epidemiology and management of Chagas disease. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Occupational foot-transmitted vibration (FTV) exposure is common in industries like mining, construction, and agriculture, often leading to acute and chronic injuries. Vibration assessments require technical expertise and equipment which can be costly for employers to perform. Alternatively, researchers have observed that self-reported discomfort can be used as an effective indicator of injury risk., Objective: This study aimed to investigate the effect of standing FTV exposure on self-reported ratings of discomfort, and whether these subjective ratings differed by body area and exposure frequency., Methods: Participants (n = 30) were randomly exposed to standing FTV at six frequencies (25, 30, 35, 40, 45, and 50 Hz) for 20-45 seconds. Following each exposure, participants rated discomfort on a scale of 0-9 in four body areas: head and neck (HN), upper body (UB), lower body (LB), and total body., Results: Results indicated that participants experienced the most discomfort in the LB at higher frequencies (p < 0.001), consistent with the resonance of foot structures. The HN discomfort tended to decrease as the exposure frequency increased, although not statistically significant (p > 0.0167). The UB discomfort remained relatively low across all frequencies., Conclusions: The study suggests a potential connection between resonant frequencies and discomfort, potentially indicating injury risk. Although self-reported discomfort is insufficient for directly assessing injury risk from FTV, it provides a simple method for monitoring potential musculoskeletal risks related to vibration exposure at resonant frequencies. While professional vibration assessment remains necessary, self-reported discomfort may act as an early indicated of vibration-induced injuries, aiding in implementing mitigation strategies.

Dopamine (DA) is involved in stress and stress-related illnesses, including many psychiatric disorders. Corticotropin-releasing factor (CRF) plays a role in stress responses and targets the ventral midbrain DA system, which is composed of DA and non-DA cells, and divided into specific subregions. Although CRF inputs to the midline A10 nuclei ("classic VTA") are known, in monkeys, CRF-containing terminals are also highly enriched in the expanded A10 parabrachial pigmented nucleus (PBP) and in the A8 retrorubral field subregions. We characterized CRF-labeled synaptic terminals on DA (tyrosine hydroxylase, TH+) and non-DA (TH-) cell types in the PBP and A8 regions using immunoreactive electron microscopy (EM) in male and female macaques. CRF labeling was present mostly in axon terminals, which mainly contacted TH-negative dendrites in both subregions. Most CRF-positive terminals had symmetric profiles. In both PBP and A8, CRF symmetric (putative inhibitory) synapses onto TH-negative dendrites were significantly greater than asymmetric (putative excitatory) profiles. This overall pattern was similar in males and females, despite shifts in the size of these effects between regions depending on sex. Because stress and gonadal hormone shifts can influence CRF expression, we also did hormonal assays over a 6-month time period and found little variability in basal cortisol across similarly housed animals at the same age. Together our findings suggest that at baseline, CRF-positive synaptic terminals in the primate PBP and A8 are poised to regulate DA indirectly through synaptic contacts onto non-DA neurons., (© 2023 Wiley Periodicals LLC.)

Distal femoral skeletal traction is a common procedure for the stabilization of fractures of the pelvis, acetabulum, and femur following trauma. Femoral traction pins are traditionally inserted via medial-to-lateral (MTL) entry to accurately direct the pin away from the medial neurovascular bundle. Alternatively, cadaveric studies have demonstrated low risk to the neurovascular bundle using a lateral-to-medial (LTM) approach. The purpose of this study was to compare the incidence of complications of LTM and MTL femoral traction pin placement at a single institution. This was a retrospective review of patients from the orthopaedic consult registry at a academic Level I Trauma Center. We identified 233 LTM femoral traction pin procedures in 231 patients and 29 MTL pin procedures in 29 patients. The two pin placement techniques were compared with respect to complications, specifically the incidence of neurovascular injury, cellulitis, septic arthritis, osteomyelitis, and heterotopic ossification after femoral traction pin placement. Two complications were reported. One patient developed heterotopic ossification along the pin tract after LTM traction pin placement. Another patient developed septic arthritis after LTM pin placement, likely attributable to retrograde intramedullary nailing of his open femur fracture rather than his traction pin. There were no reports of neurovascular injury, cellulitis, or osteomyelitis associated with pin placement. The complication rate was 0.9% for LTM group and 0.0% for MTL group (p = 0.616). LTM femoral traction pin placement is a safe procedure with a similarly low complication rate compared with traditional MTL placement when the limb is positioned in neutral alignment. (Journal of Surgical Orthopaedic Advances 32(4):259-262, 2023).

Background: Breastfeeding rates in the United States are suboptimal despite public health recommendations that infants are fed breastmilk for their first year of life. This study aimed to characterize the influence of social determinants of health on intended breastfeeding duration., Methods: This case-control study analyzed breastfeeding intent in 421 postpartum women. Data on social determinants and medical history were obtained from medical records and participant self-report. Logistic regression estimated the influence of demographic factors and social determinants on intent to breastfeed for durations of <6 months, 6-12 months, and at least 1 year., Results: Thirty-five percent of mothers intended to breastfeed for at least 6 months, and 15% for 1 year. Social determinants that negatively predicted breastfeeding intent included not owning transportation and living in a dangerous neighborhood (p < 0.05). Women were more likely to intend to breastfeed for 12 months if they had knowledge of breastfeeding recommendations (adjusted odds ratio [aOR] 6.19, 95% confidence interval [CI 2.67-14.34]), an identifiable medical provider (aOR 2.64 [CI 1.22-5.72]), familial support (aOR 2.80 [CI 1.01-7.80]), or were married (aOR 2.55 [CI 1.01-6.46]). Sociodemographic factors that negatively influenced breastfeeding intent included non-Hispanic Black race, no high school diploma, cigarette use, income below $20,000, fewer than five prenatal visits, and WIC or Medicaid enrollment (p < 0.05)., Conclusions: Women who lack familial support, an identifiable healthcare provider, or knowledge of breastfeeding guidelines are less likely to intend to breastfeed. Public health initiatives should address these determinants to improve breastfeeding and infant outcomes., (© 2023 The Authors. Birth published by Wiley Periodicals LLC.)

Background: The aim of this study is to gather detailed insights from breast cancer (BC) clinicians on how to have patient-centered conversations about weight and weight management with women diagnosed with early BC. A high body mass index (BMI) is a risk factor for female BC, and many women diagnosed with BC experience unhealthy weight gain after their primary treatment. The oncology team has the opportunity to discuss the importance of healthy weight for BC prognosis and survival., Methods: The sample of community-based BC clinicians included the following: three Black clinicians, three White clinicians, and two clinicians who were neither Black nor White; six females and two males; and six MDs and two physician assistants or nurse practitioners. Semistructured telephone interviews were conducted with these clinicians regarding their experience with and insights into having healthy weight conversations during routine clinic visits., Results: Clinicians noted that weight-related conversations should focus less on BMI and weight loss and more on "healthy behavior." Clinicians looked for cues from their patients as to when they were ready for "healthy weight" counseling, receptive to diet/nutrition counseling and referrals, and ready to attempt behavioral change. Clinicians noted that encouraging physical activity could be especially challenging with patients accustomed to a sedentary lifestyle., Conclusions: Clinic-based conversations about healthy weight are likely to be most productive for both patients and their treating oncologists during the post-primary treatment phase when patients are most receptive to behavioral change that enhances their prognosis and survival., (© 2022 American Cancer Society.)

Apples grown in high heat, high light, and low humidity environments are at risk for sun injury disorders like sunburn and associated crop losses. Understanding the physiological and molecular mechanisms underlying sunburn will support improvement of mitigation strategies and breeding for more resilient varieties. Numerous studies have highlighted key biochemical processes involved in sun injury, such as the phenylpropanoid and reactive oxygen species (ROS) pathways, demonstrating both enzyme activities and expression of related genes in response to sunburn conditions. Most previous studies have focused on at-harvest activity of a small number of genes in response to heat stress. Thus, it remains unclear how stress events earlier in the season affect physiology and gene expression. Here, we applied heat stress to mid-season apples in the field and collected tissue along a time course-24, 48, and 72 h following a heat stimulus-to investigate dynamic gene expression changes using a transcriptomic lens. We found a relatively small number of differentially expressed genes (DEGs) and enriched functional terms in response to heat treatments. Only a few of these belonged to pathways previously described to be involved in sunburn, such as the AsA-GSH pathway, while most DEGs had not yet been implicated in sunburn or heat stress in pome fruit., Competing Interests: Conflicts of interest The authors declare no conflict of interest., (Published by Oxford University Press on behalf of The Genetics Society of America 2023.)

Context: Although the physiological effects and the performance of athletes after utilizing whole-body cryotherapy (WBC) have been widely studied, there is a lack of data on its adverse effects. It is important to be aware of the adverse effects of any treatment for its use to be properly recommended., Objectives: This study aims to provide insight to any adverse effects that collegiate athletes experienced after utilizing WBC to better utilize this therapeutic modality., Methods: After the Institutional Review Board (IRB) deemed exemption, all 457 Division 1-A varsity athletes were recruited via email to participate in a retrospective survey. Participants consented to the study by continuing to the questions. The inclusion criteria were that they must be 18 years of age or older, had completed WBC at that university, and were a student-athlete. The survey was six questions long, and if any of the inclusion criteria was not met, they were redirected to end the survey. The data were analyzed utilizing odds ratios., Results: Of the 457 student-athletes, 11.2% (n=51) responded and 6.3% (n=29) met the inclusion criteria. Responses were obtained from women's lacrosse (27.6%; n=8), women's gymnastics (24.1%, n=7), field hockey (17.2%, n=5), wrestling (6.9%, n=2), football (6.9%, n=2), women's cross country (3.5%, n=1), men's basketball (3.5%, n=1), women's volleyball (3.5%, n=1), softball (3.5%, n=1), and baseball (3.5%, n=1). Among the responses, 79.3% (n=23) were females and 29.7% (n=6) were males. Within 1 h of WBC, the most frequently reported adverse effects were skin rash (27.6%, n=8), itching (13.8%, n=4), and fatigue (6.9%, n=2). More than 1 h after WBC, the most frequently reported adverse effects were skin rash (20.7%, n=6), itching (10.3%, n=3), and increased energy (6.9%, n=2). When stratified by female and male athletes, for both within 1 h and more than 1 h after WBC, there were increased odds for females reporting adverse effects; however, neither were statistically significant (OR 4.58, p=0.19, 95% CI 0.46 to 45.61) (OR 3.84, p=0.25, 95% CI 0.39 to 38.36). Within 1 h of WBC, 58.6% (n=17) of subjects reported no adverse effects, and more than 1 h after WBC, 65.5% (n=19) subjects reported no adverse effects. The mean satisfaction level rating was 6.34 (range 0-10, n=29). When asked if they would do WBC again, 65.5% (n=19) responded "yes" and 34.5% (n=10) responded "no.", Conclusions: In this collegiate athlete population, negative adverse effects of WBC commonly included skin burns and itching while potentially proving a beneficial adverse effect of increased energy. Subjects commonly reported no adverse effects after WBC treatment as well., (© 2023 the author(s), published by De Gruyter, Berlin/Boston.)

Purpose: To examine the impact of the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine (ACOG-SMFM) 2014 recommendations for preventing unnecessary primary Cesareans., Methods: In a population-based cohort of births in New York City from 2012 to 2016, we used controlled interrupted time series analyses to estimate changes in age-standardized Cesarean rates among nulliparous, term, singleton vertex (NTSV) deliveries., Results: Among 192,405 NTSV births across 40 hospitals, the age-standardized NTSV Cesarean rate decreased after the ACOG-SMFM recommendations from 25.8% to 24.0% (Risk ratio [RR]: 0.93; 95% CI 0.89, 0.97), with no change in the control series. Decreases were observed among non-Hispanic White women (RR: 0.89; 95% CI 0.82, 0.97), but not among non-Hispanic Black women (RR: 0.97; 95% CI 0.88, 1.07), Asian/Pacific Islanders (RR: 1.01; 95% CI 0.91, 1.12), or Hispanic women (RR: 0.94; 95% CI 0.86, 1.02). Similar patterns were observed at teaching hospitals, with no change at nonteaching hospitals., Conclusions: While low-risk Cesarean rates may be modifiable through changes in labor management, additional research, and interventions to address Cesarean disparities, are needed., (Copyright © 2023 Elsevier Inc. All rights reserved.)

The central extended amygdala (CEA) and ventral pallidum (VP) are involved in diverse motivated behaviors based on rodent models. These structures are conserved, but expanded, in higher primates, including human. Corticotropin releasing factor (CRF), a canonical "stress molecule" associated with the CEA and VP circuitry across species, is dynamically regulated by stress and drugs of abuse and misuse. CRF's effects on circuits critically depend on its colocation with primary "fast" transmitters, making this crucial for understanding circuit effects. We surveyed the distribution and colocalization of CRF-, VGluT2- (vesicular glutamate transporter 2), and VGAT- (vesicular GABA transporter) mRNA in specific subregions of the CEA and VP in young male monkeys. Although CRF-containing neurons were clustered in the lateral central bed nucleus (BSTLcn), the majority were broadly dispersed throughout other CEA subregions, and the VP. CRF/VGAT-only neurons were highest in the BSTLcn, lateral central amygdala nucleus (CeLcn), and medial central amygdala nucleus (CeM) (74%, 73%, and 85%, respectively). In contrast, lower percentages of CRF/VGAT only neurons populated the sublenticular extended amygdala (SLEAc), ventrolateral bed nucleus (BSTLP), and VP (53%, 54%, 17%, respectively), which had higher complements of CRF/VGAT/VGluT2-labeled neurons (33%, 29%, 67%, respectively). Thus, the majority of CRF-neurons at the "poles" (BSTLcn and CeLcn/CeM) of the CEA are inhibitory, while the "extended" BSTLP and SLEAc subregions, and neighboring VP, have a more complex profile with admixtures of "multiplexed" excitatory CRF neurons. CRF's colocalization with its various fast transmitters is likely circuit-specific, and relevant for understanding CRF actions on specific target sites. SIGNIFICANCE STATEMENT The central extended amygdala (CEA) and ventral pallidum (VP) regulate multiple motivated behaviors through differential downstream projections. The stress neuropeptide corticotropin releasing factor (CRF) is enriched in the CEA, and is thought to "set the gain" through modulatory effects on coexpressed primary transmitters. Using protein and transcript assays in monkey, we found that CRF neurons are broadly and diffusely distributed in CEA and VP. CRF mRNA + neurons colocalize with VGAT (GABA) and VGluT2 (glutamate) mRNAs in different proportions depending on subregion. CRF mRNA was also coexpressed in a subpopulation of VGAT/VGluT2 mRNA ("multiplexed") cells, which were most prominent in the VP and "pallidal"-like parts of the CEA. Heterogeneous CRF and fast transmitter coexpression across CEA/VP subregions implies circuit-specific effects., (Copyright © 2022 Fudge et al.)

Stimuli-responsive materials are crucial to advance controlled delivery systems for drugs and catalysts. Lyotropic liquid crystals (LLCs) have well-defined internal structures suitable to entrap small molecules and can be broken up into low-viscosity dispersions, aiding their application as delivery systems. In this work, we demonstrate the first example of light-responsive cubic LLC dispersions, or cubosomes, using photoswitchable amphiphiles to enable external control over the LLC structure and subsequent on-demand release of entrapped guest molecules. Azobenzene photosurfactants (AzoPS), containing a neutral tetraethylene glycol head group and azobenzene-alkyl tail, are combined (from 10-30 wt %) into monoolein-water systems to create LLC phases. Homogenization of the bulk LLC forms dispersions of particles, ∼200 nm in diameter with internal bicontinuous primitive cubic phases, as seen using small-angle X-ray scattering and cryo-transmission electron microscopy. Notably, increasing the AzoPS concentration leads to swelling of the cubic lattice, offering a method to tune the internal nanoscale structure. Upon UV irradiation, AzoPS within the cubosomes isomerizes within seconds, which in turn leads to squeezing of the cubic lattice and a decrease in the lattice parameter. This squeeze mechanism was successfully harnessed to enable phototriggerable release of trapped Nile Red guest molecules from the cubosome structure in minutes. The ability to control the internal structure of LLC dispersions using light, and the dramatic effect this has on the retention of entrapped molecules, suggests that these systems may have huge potential for the next-generation of nanodelivery.

Purpose: We aimed to quantify general and specific contextual effects associated with Cesarean delivery at New York City hospitals, overall and by maternal race/ethnicity., Methods: Among 127,449 singleton, nulliparous births at New York City hospitals from 2015 to 2017, we used multilevel logistic regression to examine the association of hospital characteristics (public/private ownership, teaching status and delivery caseloads) with Cesarean delivery, overall, and by maternal race/ethnicity. We estimated the intra-class correlation to examine general contextual effects and 80% interval odds ratios (IOR) and percentage of opposed odds ratios (POOR) to examine specific contextual effects., Results: Overall, 27.8% of births were Cesareans. The general contextual (hospital) effect on Cesarean delivery was small (intra-class correlation: 1.8%). Hospital characteristics associated with Cesarean delivery differed by maternal race/ethnicity, with delivery in teaching hospitals reducing the odds of Cesarean delivery among White (IOR: 0.31, 0.86; POOR: 4.7%) and Asian women (IOR: 0.41, 0.95; POOR: 7.3%), but not among Black (IOR: 0.51, 1.34; POOR: 30.7%) or Hispanic women (IOR: 0.44, 1.24; POOR: 22.6%). Hospital ownership and caseloads were not associated with Cesarean delivery for any group., Conclusions: There is little within-hospital clustering of Cesarean delivery, suggesting that Cesarean disparities may not be explained by hospital of delivery., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Luminescent solar concentrators (LSCs) are an emerging technology to collect and channel light from a large absorption area into a smaller one. They are a complementary technology for traditional solar photovoltaics (PV), particularly suitable for application in urban or indoor environments where their custom colors and form factors, and performance under diffuse light conditions may be advantageous. Förster resonance energy transfer (FRET) has emerged as a valuable approach to overcome some of the intrinsic limitations of conventional single lumophore LSCs, such as reabsorption or reduced quantum efficiency. This review outlines the potential of FRET to boost LSC performance, using highlights from the literature to illustrate the key criteria that must be considered when designing an FRET-LSC, including both the photophysical requirements of the FRET lumophores and their interaction with the host material. Based on these criteria, a list of design guidelines intended to aid researchers when they approach the design of a new FRET-LSC system is presented. By highlighting the unanswered questions in this field, the authors aim to demonstrate the potential of FRET-LSCs for both conventional solar-harvesting and emerging LSC-inspired technologies and hope to encourage participation from a diverse researcher base to address this exciting challenge., (© 2022 The Authors. Advanced Science published by Wiley-VCH GmbH.)

The ventral midbrain is the primary source of dopamine- (DA) expressing neurons in most species. GABA-ergic and glutamatergic cell populations are intermixed among DA-expressing cells and purported to regulate both local and long-range dopamine neuron activity. Most work has been conducted in rodent models, however due to evolutionary expansion of the ventral midbrain in primates, the increased size and complexity of DA subpopulations warrants further investigation. Here, we quantified the number of DA neurons, and their GABA-ergic complement in classic DA cell groups A10 (midline ventral tegmental area nuclei [VTA] and parabrachial pigmented nucleus [PBP]), A9 (substantia nigra, pars compacta [SNc]) and A8 (retrorubral field [RRF]) in the macaque. Because the PBP is a disproportionately expanded feature of the A10 group, and has unique connectional features in monkeys, we analyzed A10 data by dividing it into 'classic' midline nuclei and the PBP. Unbiased stereology revealed total putative DA neuron counts to be 210,238 ± 17,127 (A10 = 110,319 ± 9649, A9 = 87,399 ± 7751 and A8 = 12,520 ± 827). Putative GABAergic neurons were fewer overall, and evenly dispersed across the DA subpopulations (GAD67 = 71,215 ± 5663; A10 = 16,836 ± 2743; A9 = 24,855 ± 3144 and A8 = 12,633 ± 3557). Calculating the GAD67/TH ratio for each subregion revealed differential balances of these two cell types across the DA subregions. The A8 subregion had the highest complement of GAD67-positive neurons compared to TH-positive neurons (1:1), suggesting a potentially high capacity for GABAergic inhibition of DA output in this region., (Copyright © 2022 IBRO. Published by Elsevier Ltd. All rights reserved.)

The subgenual (sgACC) and perigenual (pgACC) anterior cingulate are important afferents of the amygdala, with different cytoarchitecture, connectivity, and function. The sgACC is associated with arousal mechanisms linked to salient cues, whereas the pgACC is engaged in conflict decision-making, including in social contexts. After placing same-size, small volume tracer injections into sgACC and pgACC of the same hemisphere in male macaques, we examined anterogradely labeled fiber distribution to understand how these different functional systems communicate in the main amygdala nuclei at both mesocopic and cellular levels. The sgACC has broad-based termination patterns. In contrast, the pgACC has a more restricted pattern, which was always nested in sgACC terminals. Terminal overlap occurred in subregions of the accessory basal and basal nuclei, which we termed "hotspots." In triple-labeling confocal studies, the majority of randomly selected CaMKIIα-positive cells (putative amygdala glutamatergic neurons) in hotspots received dual contacts from the sgACC and pgACC. The ratio of dual contacts occurred over a surprisingly narrow range, suggesting a consistent, tight balance of afferent contacts on postsynaptic neurons. Large boutons, which are associated with greater synaptic strength, were ∼3 times more frequent on sgACC versus pgACC axon terminals in hotspots, consistent with a fast "driver" function. Together, the results reveal a nested interaction in which pgACC ("conflict/social monitoring") terminals converge with the broader sgACC ("salience") terminals at both the mesoscopic and cellular level. The presynaptic organization in hotspots suggests that shifts in arousal states can rapidly and flexibly influence decision-making functions in the amygdala. SIGNIFICANCE STATEMENT The subgenual (sgACC) and perigenual cingulate (pgACC) have distinct structural and functional characteristics and are important afferent modulators of the amygdala. The sgACC is critical for arousal, whereas the pgACC mediates conflict-monitoring, including in social contexts. Using dual tracer injections in the same monkey, we found that sgACC inputs broadly project in the main amygdala nuclei, whereas pgACC inputs were more restricted and nested in zones containing sgACC terminals (hotspots). The majority of CaMKIIα + (excitatory) amygdala neurons in hotspots received converging contacts, which were tightly balanced. pgACC and sgACC afferent streams are therefore highly interdependent in these specific amygdala subregions, permitting "internal arousal" states to rapidly shape responses of amygdala neurons involved in conflict and social monitoring networks., (Copyright © 2021 the authors.)