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Anna Pomerenke,1 Simon R Lea,1 Sarah Herrick,2 Mark A Lindsay,3 Dave Singh1 1Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester, NHS Foundation Trust, 2Institute of Inflammation and Repair, Manchester Academic Health Science Centre, University of Manchester, Manchester, 3Department of Pharmacy and Pharmacology, University of Bath, Bath, UK Purpose: Viruses are a common cause of exacerbations in chronic obstructive pulmonary disease (COPD). They activate toll-like receptors (TLRs) 3, 7, and 8, leading to a pro-inflammatory response. We have characterized the responses of TLR3 and TLR7/8 in lung tissue explants from COPD patients and control smokers.Methods: We prepared lung whole tissue explants (WTEs) from patients undergoing surgery for confirmed or suspected lung cancer. In order to mimic the conditions of viral infection, we used poly(I:C) for TLR3 stimulation and R848 for TLR7/8 stimulation. These TLR ligands were used alone and in combination. The effects of tumor necrosis factor α (TNFα) neutralization and dexamethasone on TLR responses were examined. Inflammatory cytokine release was measured by enzyme-linked immunosorbent assay and gene expression by quantitative real-time polymerase chain reaction.Results: WTEs from COPD patients released higher levels of pro-inflammatory cytokines compared with WTEs from smokers. Activation of multiple TLRs led to a greater than additive release of TNFα and CCL5. TNFα neutralization and dexamethasone treatment decreased cytokine release.Conclusion: This WTE model shows an enhanced response of COPD compared with controls, suggesting an increased response to viral infection. There was amplification of innate immune responses with multiple TLR stimulation. Keywords: COPD, poly(I:C), R848, cytokines, lung explant

Abstract Endocrine therapy (ET) for breast cancer treatment is associated with cognitive complaints, but their etiology is poorly understood. To address this, we developed and implemented an ambulatory assessment protocol consisting of wearable activity monitors, brief surveys of affect, context, and perceived impairments, and ultra-brief performance-based measures of cognition. Newly diagnosed, ER/PR+, stage 0-III, female breast cancer patients, were recruited. Ambulatory assessments were conducted on smart phones and wearable activity monitors were used to monitor sleep and physical activity. Participants were asked to complete five 7-day measurement bursts (one before starting ET and one each month for 4 consecutive months while on ET). We observed a consent rate of 36%, 27 women completed the study. Of the women that withdrew, 91% dropped prior to the midpoint of follow up. There were no significant differences in demographics, clinical breast cancer characteristics, sleep or physical activity patterns, or measures of cognition between women who completed versus withdrew. Women who did not complete the study provided fewer valid days of baseline data. In conclusion, while some women may be overwhelmed with their cancer diagnosis, we did not identify any predictive characteristics of women whom did not complete the study. This novel method enables the prospective study of psychological changes associated with cancer treatment, capturing a wide array of information about behavior, experience, and cognition, thus providing a picture of the lived experiences of cancer patients before and during exposure to ET.

Abstract. Introduction:. In 85% of patients with chronic low back pain (CLBP), no specific pathoanatomical cause can be identified. Besides primary peripheral drivers within the lower back, spinal or supraspinal sensitization processes might contribute to the patients' pain. Objectives:. The present study conceptualized the most painful area (MP) of patients with nonspecific CLBP as primarily affected area and assessed signs of peripheral, spinal, and supraspinal sensitization using quantitative sensory testing (QST) in MP, a pain-free area adjacent to MP (AD), and a remote, pain-free control area (CON). Methods:. Fifty-nine patients with CLBP (51 years, SD = 16.6, 22 female patients) and 35 pain-free control participants individually matched for age, sex, and testing areas (49 years, SD = 17.5, 19 female participants) underwent a full QST protocol in MP and a reduced QST protocol assessing sensory gain in AD and CON. Quantitative sensory testing measures, except paradoxical heat sensations and dynamic mechanical allodynia (DMA), were Z-transformed to the matched control participants and tested for significance using Z-tests (α = 0.001). Paradoxical heat sensations and DMA occurrence were compared between cohorts using Fisher's exact tests (α = 0.05). The same analyses were performed with a high-pain and a low-pain CLBP subsample (50% quantile). Results:. Patients showed cold and vibration hypoesthesia in MP (all Ps < 0.001) and mechanical hyperalgesia (P < 0.001) and more frequent DMA (P = 0.044) in AD. The results were mainly driven by the high-pain CLBP subsample. In CON, no sensory alterations were observed. Conclusion:. Mechanical hyperalgesia and DMA adjacent to but not within MP, the supposedly primarily affected area, might reflect secondary hyperalgesia originating from spinal sensitization in patients with CLBP.

Abstract Oxylipins, small polar molecules derived from the peroxidation of polyunsaturated fatty acids (PUFAs), serve as biomarkers for many diseases and play crucial roles in human physiology and inflammation. Despite their significance, many non-enzymatic oxygenated metabolites of PUFAs (NEO-PUFAs) remain poorly reported, resulting in a lack of public datasets of experimental data and limiting their dereplication in further studies. To overcome this limitation, we constructed a high-resolution tandem mass spectrometry (MS/MS) dataset comprising pure NEO-PUFAs (both commercial and self-synthesized) and in vitro free radical-induced oxidation of diverse PUFAs. By employing molecular networking techniques with this dataset and the existent ones in public repositories, we successfully mapped a wide range of NEO-PUFAs, expanding the strategies for annotating oxylipins, and NEO-PUFAs and offering a novel workflow for profiling these molecules in biological samples.

Background and Aims: Inflammatory bowel diseases (IBDs) are chronic inflammatory conditions influenced heavily by environmental factors. DNA methylation is a form of epigenetic regulation linking environmental stimuli to gene expression changes and inflammation. Here, we investigated how DNA methylation of the tumor necrosis factor (TNF) promoter differs between inflamed and uninflamed mucosa of IBD patients, including anti-TNF responders and nonresponders. Methods: We obtained mucosal biopsies from 200 participants (133 IBDs and 67 controls) and analyzed TNF promoter methylation using bisulfite sequencing, comparing inflamed with uninflamed segments, in addition to paired inflamed/uninflamed samples from individual patients. We conducted similar analyses on purified intestinal epithelial cells from bowel resections. We also compared TNF methylation levels of inflamed and uninflamed mucosa from a separate cohort of 15 anti-TNF responders and 17 nonresponders. Finally, we sequenced DNA methyltransferase genes to identify rare variants in IBD patients and functionally tested them using rescue experiments in a zebrafish genetic model of DNA methylation deficiency. Results: TNF promoter methylation levels were decreased in inflamed mucosa of IBD patients and correlated with disease severity. Isolated intestinal epithelial cells from inflamed tissue showed proportional decreases in TNF methylation. Anti-TNF nonresponders showed lower levels of TNF methylation than responders in uninflamed mucosa. Our sequencing analysis revealed 2 missense variants in DNA methyltransferase 1, 1 of which had reduced function in vivo. Conclusion: Our study reveals an association of TNF promoter hypomethylation with mucosal inflammation, suggesting that IBD patients may be particularly sensitive to inflammatory environmental insults affecting DNA methylation. Together, our analyses indicate that TNF promoter methylation analysis may aid in the characterization of IBD status and evaluation of anti-TNF therapy response.

Background: To assess an individual's cognitive and emotional representation of illness, a translated, culturally adapted brief illness perception questionnaire (B-IPQ) is needed. Objective: This study assessed the content validity and face validity of a Gujarati version of a B-IPQ questionnaire. Materials and Methods: A forward–backward translation of the 9-item B-IPQ was applied using a standardized approach. The translated versions were compared with the original questionnaire, and 10 experts rated each item according to the following criteria: clarity, semantic equivalence, appropriateness, and cultural relevance. Data were analyzed by calculating the content validity and universal agreement (UA) between experts. Face validity was assessed using a think-aloud approach with 10 patients with intermittent claudication. This cognitive interviewing approach asked participants to describe their thoughts while completing the questionnaire to explore the comprehensibility and clarity of the translated questionnaire. Responses were analyzed using deductive thematic analysis. Results: There was a complete agreement between experts for 8/9 items (I-CVI = 1.00), leading to an overall agreement (S-CVI/Ave) of 0.98. There was an excellent agreement between experts (UA = 0.88). For face validation, our participants encountered only minor problems understanding some of the questions, and the Gujarati B-IPQ was considered to have good face validity. Conclusion: B-IPQ questionnaire had excellent content validity and good face validity and will enable illness perception to be assessed in people with IC.

Background: The HeartWare ventricular assist device (HVAD) was discontinued in July 2021. The study aims to describe the impact the discontinuation the HVAD had on pediatric ventricular assist device (VAD) utilization and outcomes. Methods: The Advanced Cardiac Therapies Improving Outcomes Network (ACTION) registry was queried for type of VAD utilization and outcomes/adverse event rates in patients with a body surface area of 0.7 to 1.4 m2. Results were compared from before and after July 2021. All patients in the registry implanted with an HVAD were reported to determine overall outcomes of these patients and define who remains on the device. Results: The HeartMate 3 (HM3) primarily replaced the HVAD in pediatric patients increasing from 29 of 258 (11%) of implants before July 2021 to 31 of 109 (29%) of implants after. A small increase in the use of the Berlin Heart EXCOR (40 of 258, 16% before to 20 of 109, 18% after) and paracorporeal continuous flow devices (116 of 258, 45% before to 58 of 109, 53% after) was also observed. The rate of ischemic stroke increased in the overall population and a decrease in bleeding complications in the EXCOR group was observed. Of the 187 pediatric patients implanted with an HVAD in the registry, 7 patients remain supported, 1 patient transitioned from the HVAD to an HM3, and 6 patients were lost to follow-up. Conclusions: The HM3 has been the primary replacement for the HVAD in the medium-sized pediatric population. The rate of ischemic stroke was higher after July 2021.

Abstract Objective Unlike randomized controlled trials, practical real‐world studies can offer important information about implementation of prehospital interventions, particularly in community settings where there may be reluctance to adopt new practices. We present the results of a natural experiment that was driven by mandated COVID‐19 pandemic‐driven shift from endotracheal intubation (ETI) to the i‐gel® supraglottic airway (SGA) as a primary advanced airway management device in the prehospital setting to reduce emergency medical services (EMS) personnel exposure to potentially infectious secretions. The objective was to compare first‐pass success and timing to successful airway placement between ETI and the i‐gel® SGA under extenuating circumstances. Methods This pre/post study compared airway placement metrics in prehospital patients requiring advance airway management for non‐trauma‐related conditions. Data from EMS records were extracted over 2 years, 12 months pre‐pandemic, and 12 months post‐pandemic. During the pre‐COVID‐19 year, the EMS protocols utilized ETI as the primary advanced airway device (ETI group). Post‐pandemic paramedics were mandated to utilize i‐gel® SGA as the primary advanced airway device to reduce exposure to secretions (SGA group). Results There were 199 adult patients, 83 (42%) in the ETI group and 116 (58%) in the SGA group. First‐pass success was significantly higher with SGA 96% (92%–99%) than ETI 68% (57%–78%) with paramedics citing the inability to visualize the airway in 52% of ETI cases. Time to first‐pass success was significantly shorter in the SGA group (5.9 min [5.1–6.7 min]) than in the ETI group (8.3 min [6.9–9.6 min]), as was time to overall successful placement at 6.0 min (5.1–6.8 min) versus 9.6 min (8.2–11.1 min), respectively. Multiple placement attempts were required in 26% of ETI cases and 1% of the SGA cases. There were no statistically significant differences in the number and types of complications between the cohorts. Return of spontaneous circulation (on/before emergency department [ED] arrival), mortality at 28 days, intensive care unit length of stay, or ventilator‐free days between the groups were not statistically different between the groups. Conclusion In this natural experiment, the SGA performed significantly better than ETI in first‐pass airway device placement success and was significantly faster in achieving first‐pass success, and overall airway placement, thus potentially reducing exposure to respiratory pathogens. Practical real‐world studies can offer important information about implementation of prehospital interventions, particularly in community settings and in systems with a low frequency of tracheal intubations.

Recently writing centers are expanding to Asian higher education contexts. However, there is a scarcity of research from writing centers in Asian settings and from non-native English speaker (NNES) tutor perspectives. Therefore, the purpose of this study is to enrich understandings of the challenges and expectations perceived by NNES tutors during tutoring writing sessions with intermediate level Japanese EFL (English as Foreign Language) students. A qualitative approach was employed utilizing two data collection methods: 16 interviews with writing tutors, and two quasi-focus groups. Thematic analysis of the data revealed five major categories for challenges perceived by NNES tutors: miscommunication, student silence, mismatched expectations, interpretation of teacher feedback and error correction. It is argued that these are the main challenges that EFL writing tutors face and hence indicate the necessity to train tutors how to deal with them. The implications for creating Asian writing centers and tutor training are discussed.

This study expands arguments calling for a more rigorous approach to high-frequency vocabulary list-based learning in EFL learning environments. Test and flashcard item designs were validated through quantitative (midterm and final test) and qualitative (survey) results to explore the impact of digital flashcards designed to build recall-level comprehension on both timed gap-fill and traditional multiple-choice posttests. Quizlet was chosen as the platform due to the affordance it provides teachers to create flashcard content and monitor practice. The results showed that multiple-choice, recognition-level test items result in a 20% overestimation of knowledge relative to gap-fill posttests. Additionally, a post-semester survey of 138 Japanese, pre-intermediate students of English showed a highly positive response to the recall-focused practice and testing system. The results demonstrate that for high-frequency L2 vocabulary, a paradigm shift from form-meaning recognition to form-meaning recall is an important direction for high-frequency vocabulary instruction and testing.

Abstract Background Refugees have high levels of psychological distress that hamper lifestyle change efforts. We previously reported that community health educator (CHE) diabetes prevention interventions decreased HbA1c and depressive symptoms among Cambodian-American refugees with depression; this paper reports health behavior outcomes of those interventions. Methods Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either a) antidepressant medication and/or b) prolonged elevated depressive symptoms. Participants were randomized to one of three CHE interventions: 1) lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus medication therapy management with a pharmacist/CHE team (EWS + MTM), or, 3) social services (SS; control). Physical activity and sleep were measured with 7 days of actigraphy. Nutrition was measured as carbohydrates as reported in a culturally tailored food frequency questionnaire. Assessments were at baseline, end point (12 months), and follow-up (15 months). Results The n = 188 participants were 78% female, average age of 55 years, half had a household income

Objectives: Hemorrhage is a common complication of trauma. We evaluated age and sex differences in treatment with blood product transfusions and massive transfusions as well as in-hospital mortality following trauma at a Level 1 Trauma Center. Methods: This cross-sectional study evaluated trauma data from a Level 1 trauma center registry from January 2013 to December 2017. The primary outcome was amount of blood products (packed red blood cells (PRBCs), plasma, platelets), and massive transfusion (MT) by biological sex and by age group: 16-24 (youth), 25-59 (middle age), and >=60 (older age) The secondary outcome was in-hospital mortality to hospital discharge. Results: There were 13596 trauma patients in the registry, mean age was 48 years, 4589 (34%) female and 9007 (66%) male, and median ISS of 9. Male patients received significantly more PRBC transfusions than female patients within 4-hours 6.6% vs 4.4%, and 24-hours 6.7% vs 4.5% respectively. Older patients received significantly fewer PRBC transfusions within 4-hours and 24-hours than their younger counterparts, with 6.9% in the youth group, 6.8% in the middle age group, and 3.9% in the older group (p

Abstract Background Poor self-reported sleep health has been linked to not consuming breakfast in adolescents, but it is unknown whether poor sleep measured objectively predicts next-day breakfast consumption within adolescents. We investigated within- and between-person associations of objectively measured sleep dimensions and subjective sleep quality with adolescent breakfast consumption. Methods Data were collected from a micro-longitudinal substudy of the Year 15 wave of the Fragile Families and Child Wellbeing Study (n = 590). Adolescents wore an actigraphy device and completed daily diaries for ~ 1 week (M ± SD = 5.6 ± 1.4 nights per adolescent, range: 3–9), where they rated their sleep quality and reported whether they had eaten breakfast that day, with no specific definition of breakfast provided (M ± SD = 5.5 ± 1.4 days per adolescent, range: 3–9). Separate mixed models assessed whether actigraphy-measured sleep duration (linear and quadratic, sleep duration x sleep duration), timing, maintenance efficiency, and subjective quality predicted odds of breakfast consumption both within and between adolescents. Variability of sleep duration and timing (standard deviation per person), sleep regularity index (SRI), and social jetlag were tested as additional between-person predictors. Analyses with predictors other than sleep duration were adjusted for sleep duration. Results Following nights when adolescents had shorter or longer sleep duration (p = .005; curvilinear association), later sleep onset, or later sleep midpoint (both p = .025) than their own usual, they had lower odds of consuming breakfast the next day (within-person associations). Adolescents who on average had later sleep onset (p = .013) or midpoint (p = .013) or who reported lower sleep quality (p = .011) had lower average odds of consuming breakfast (between-person associations). Adolescents with greater variability of sleep duration (p = .005), midpoint (p = .004), or offset (p .10). Conclusions Multiple dimensions of sleep health are associated with breakfast consumption, both within and between adolescents. Poor sleep and dietary behaviors in adolescence may negatively impact future metabolic health.

Abstract International drug policy is rapidly evolving in tandem with promising evidence for psychedelic-assisted psychotherapy (PAP) in treating a range of mental health conditions. Canada is among the countries increasingly expanding access to psychedelic substances for therapeutic purposes. The 8-year ban on medical exemptions through the Canadian Special Access Programme was recently reversed in January 2022 and the first exemptions for legal possession and personal use of psilocybin mushrooms were granted in 2020, nearly 50 years since their criminalization. In view of the evolving evidence base and regulatory landscape for PAP illustrated by recent shifts in Canadian and international drug policy, this piece seeks to clarify the special range of factors which ought to be considered to safely expand access to psychedelics. Streamlining access to safe and evidence-based compassionate use of PAP will provide a timely treatment option to those currently in need while encouraging further research and outcome surveillance to refine best practices.

Objective and Participants: The authors sought an updated examination of attitudes toward Human Papillomavirus (HPV) catch-up vaccination among college students at a private religious university. Methods: A total of 1557 college students completed a 62-question survey of religious and HPV vaccination attitudes during the fall of 2021. Students’ willingness to receive catch-up HPV vaccination and willingness to vaccinate a future child against HPV were recorded. Results: Of the 46.8% of students who reported being unvaccinated or unaware of vaccination status, ~26% reported being uninterested in receiving catch-up HPV vaccination; ~22% of all students surveyed reported being unwilling to vaccinate a future child against HPV. The strongest predictors of vaccine hesitancy included religious concerns about sexual abstinence and safety concerns. Conclusions: College health professionals can increase the rate of HPV vaccination among college students and subsequent future generations by addressing the safety and utility of the vaccine regardless of intentions for sexual abstinence prior to marriage. Additionally, rather than a uniform approach to all students who self-identify as Christian, an effort to identify and discuss the unique religiously influenced beliefs of individual students is recommended when discussing HPV vaccination.

Abstract Background There is increasing interest in the role of community pharmacy in the early diagnosis and prevention of cancer. This study set out to examine how often community pharmacists (CPs) encourage patients to spot or respond to potential signs and symptoms of cancer, and how often they help people to make an informed decision about taking part in bowel cancer screening. Methods Data from 400 UK CPs, who completed the 2018 Cancer Research UK Healthcare Professional Tracker survey, were analysed. The primary outcomes were: ‘how often CPs encourage patients to spot or respond to potential signs and symptoms of cancer’ and ‘how often CPs encourage eligible people to make an informed decision to participate in bowel cancer screening’. Associations between behaviours and demographic and psychological variables (Capability, Opportunity and Motivation) were assessed using multivariate logistic regression. Results Most (n = 331, 82.8%) CPs reported occasionally, frequently or always encouraging patients to spot or respond to potential signs and symptoms of cancer, while only half (n = 203, 50.8%) reported occasionally, frequently or always helping people make an informed decision to participate in bowel cancer screening. Female sex (aOR: 3.20, 95%CI: 1.51, 6.81; p

Abstract Despite significant insights into the neural mechanisms of acute placebo responses, less is known about longer-term placebo responses, such as those seen in clinical trials, or their interactions with brain disease. We examined brain correlates of placebo responses in a randomized trial of a then controversial and now disproved endovascular treatment for multiple sclerosis. Patients received either balloon or sham extracranial venoplasty and were followed for 48 weeks. Venoplasty had no therapeutic effect, but a subset of both venoplasty- and sham-treated patients reported a transient improvement in health-related quality of life, suggesting a placebo response. Placebo responders did not differ from non-responders in total MRI T2 lesion load, count or location, nor were there differences in normalized brain volume, regional grey or white matter volume or cortical thickness (CT). However, responders had higher lesion activity. Graph theoretical analysis of CT covariance showed that non-responders had a more small-world-like CT architecture. In non-responders, lesion load was inversely associated with CT in somatosensory, motor and association areas, precuneus, and insula, primarily in the right hemisphere. In responders, lesion load was unrelated to CT. The neuropathological process in MS may produce in some a cortical configuration less capable of generating sustained placebo responses.

Este trabajo tiene como objetivo explorar el discurso de los estudiantes de 6 a 8 años de edad cuando reflexionan sobre las dinámicas de educación empleadas por sus progenitores. Para ello, partimos de la teoría de la autodeterminación y reflexionamos sobre las prácticas de apoyo a la autonomía y de control parental presentes en el discurso de los menores. En este sentido, comprobamos que el discurso de los estudiantes gira, principalmente, en torno a prácticas parentales de apoyo a la autonomía como la posibilidad de elección de actividades de ocio, la comunicación de problemas y preocupaciones a los progenitores y el desempeño autónomo de algunas tareas por parte de los menores. Sin embargo, también hay evidencias de que las prácticas de apoyo a la autonomía convergen con otras relacionadas con el control parental en determinadas situaciones.

Background We aim to evaluate the association between meal intervals and weight trajectory among adults from a clinical cohort. Methods and Results This is a multisite prospective cohort study of adults recruited from 3 health systems. Over the 6‐month study period, 547 participants downloaded and used a mobile application to record the timing of meals and sleep for at least 1 day. We obtained information on weight and comorbidities at each outpatient visit from electronic health records for up to 10 years before until 10 months after baseline. We used mixed linear regression to model weight trajectories. Mean age was 51.1 (SD 15.0) years, and body mass index was 30.8 (SD 7.8) kg/m2; 77.9% were women, and 77.5% reported White race. Mean interval from first to last meal was 11.5 (2.3) hours and was not associated with weight change. The number of meals per day was positively associated with weight change. The average difference in annual weight change (95% CI) associated with an increase of 1 daily meal was 0.28 kg (0.02–0.53). Conclusions Number of daily meals was positively associated with weight change over 6 years. Our findings did not support the use of time‐restricted eating as a strategy for long‐term weight loss in a general medical population.

There is an urgent need for transformational change in agriculture to address current and future issues caused by climate change, biodiversity loss and socio-ecological disruption. But change is slow to come and is hindered by a lack of transdisciplinary evidence on potential approaches which take a systems approach. The research described here was co-developed with the Pasture Fed Livestock Association in the UK to objectively evidence their practices. These include producing pasture-based meat from livestock fed on pasture and pasture-based forages alone. This approach sits alongside wider aims of fitting their practices with the ecological conditions on each individual farm to facilitate optimal production and working collaboratively through a forum for sharing knowledge. The research provides strong indications that the PFLA approach to livestock production is resilient and viable, as well as contributing to wider public goods delivery, despite variability within and between farms. It also reveals that learning and adaption of practice (through farmer experience) is central to farming using agro-ecological approaches. This fluidity of practice presents challenges for reductionist approaches to “measuring” agricultural innovations.

Efforts to promote diversity and inclusion often lack a theoretical basis, which can unintentionally exacerbate issues. In this paper, we describe the development and evaluation results of a theoretically grounded workshop aimed at reducing microaggressions and promoting ally engagement among graduate students in science and engineering. In Study 1, using a Delphi method, eight science and engineering faculty members with backgrounds in diversity efforts provided feedback on workshop development. In Study 2, 107 graduate and advanced undergraduate students engaged in the 90-minute interactive workshop. Results indicate that attendees found the workshop valuable, developed new skills for ally engagement, and planned to engage as an ally moving forward (all averages of closed-ended assessments were 4.21 out of 5.00 or higher). Themes that were identified from qualitative responses mapped onto learning objectives, including raised awareness about microaggressions, sufficient practice, and confidence to improve one’s academic climate. Although microaggressions are common in science and engineering spaces, the present findings illustrated that, for many attendees, the information was new, including research on microaggressions and evidence-based ally strategies. This study offers a theoretically grounded intervention that facilitates intentional behavioral changes, which can help students change norms to support the advancement of women and people of color.

Abstract Emphysema is a common phenotype of chronic obstructive pulmonary disease (COPD). Although resection of emphysematous tissue can improve lung mechanics, it is invasive and fraught with adverse effects. Meanwhile, radiofrequency (RF) treatment is an extracorporeal method that leads to tissue destruction and remodeling, resulting in “volume reduction” and overall improvement in lung compliance of emphysematous lungs. Whether these changes lead to improved exercise tolerance is unknown. Here, we investigated the effectiveness of RF treatment to improve the exercise capacity of mice with emphysema. Fifty-two mice (7 weeks of age) were used in this experiment. A bilateral emphysema model was created by intratracheally instilling porcine pancreatic elastase (PPE) (1.5U/100 g body weight). RF treatment (0.5 W/ g body weight) was administered extracorporeally 14 days later and mice were sacrificed after another 21 days. The exercise capacity of mice was measured using a treadmill. Treadmill runs were performed just before PPE instillation (baseline), before RF treatment and before sacrifice. Following sacrifice, lung compliance and mean linear intercept (Lm) were measured and fibrosis was assessed using a modified Ashcroft score. There were 3 experimental groups: controls (instilled with saline, n = 12), emphysema (instilled with porcine pancreatic elastase, PPE, n = 11) and emphysema + treatment (instilled with PPE and given RF, n = 9). At endpoint, the maximum velocity of the emphysema + treatment group was significantly higher than that of the emphysema group, indicating improved exercise tolerance (86.29% of baseline vs 61.69% of baseline, p = 0.01). Histological analysis revealed a significant reduction in emphysema as denoted by Lm between the two groups (median 29.60 µm vs 35.68 µm, p = 0.03). The emphysema + treatment group also demonstrated a higher prevalence of lung fibrosis (≧Grade 3) compared with the emphysema group (11.7% vs 5.4%, p

Barriers, facilitators, and motivators to exercise for cancer survivors living in urban settings are well described in the literature. However, there is a lack of comparable information for cancer survivors living in rural communities. We describe the exercise behaviours, barriers, facilitators, and motivators to exercise participation of cancer survivors living in a rural Canadian community. Adult cancer survivors with a primary address in a rural region of Ontario, Canada, who had visited a community hospital in the previous five years were mailed a cross-sectional survey assessing current exercise volume (minutes of moderate-to-vigorous aerobic and resistance exercise), as well as exercise preferences, barriers, and facilitators. Seventy-two survivors (mean age 65 years) completed the survey (16% response rate). A majority of respondents were diagnosed with breast cancer (49%) in the last 5 years (61%). Aerobic- and resistance-training guidelines for cancer survivors were met by 38% and 10% of respondents, respectively. Physical side effects were the most common barrier to exercise during treatment (65%) and post-treatment (35%). Being unaware of available exercise programs, time for exercise, distance to exercise services, and cost were commonly reported barriers during and post-treatment (reported by 10–22%). Respondents reported needing information from a qualified exercise professional (46%), access to a gym (33%) and exercise equipment (26%), and social support (25%) to facilitate exercise participation. Consistent with urban-based cancer survivors, most rural survivors surveyed in this study were not meeting the physical-activity guidelines and reported numerous exercise barriers. These findings can serve as a resource for this and similar rural communities when developing community-based exercise-support services for cancer survivors.

Abstract Background High coverage of care is essential to improving newborn survival; however, gaps exist in access to timely and appropriate newborn care between and within countries. In high mortality burden settings, health inequities due to social and economic factors may also impact on newborn outcomes. This study aimed to examine equity in co-coverage of newborn care interventions in low- and low middle-income countries in sub-Saharan Africa and South Asia. Methods We analysed secondary data from recent Demographic and Health Surveys in 16 countries. We created a co-coverage index of five newborn care interventions. We examined differences in coverage and co-coverage of newborn care interventions by country, place of birth, and wealth quintile. Using multilevel logistic regression, we examined the association between high co-coverage of newborn care (4 or 5 interventions) and social determinants of health. Results Coverage and co-coverage of newborn care showed large between- and within-country gaps for home and facility births, with important inequities based on individual, family, contextual, and structural factors. Wealth-based inequities were smaller amongst facility births compared to non-facility births. Conclusion This analysis underlines the importance of facility birth for improved and more equitable newborn care. Shifting births to facilities, improving facility-based care, and community-based or pro-poor interventions are important to mitigate wealth-based inequities in newborn care, particularly in countries with large differences between the poorest and richest families and in countries with very low coverage of care.

Abstract Background While patient-reported treatment dissatisfaction is considered an important factor in determining the success of substance use disorder treatment, the levels of dissatisfaction with opioid agonist therapies (OAT) and its relationship with the risk of fentanyl exposure have not been characterized in the context of the ongoing opioid overdose crisis in the US and Canada. Our primary hypothesis was that OAT dissatisfaction was associated with an increased odds of fentanyl exposure. Methods Our objective was to examine self-reported treatment satisfaction among OAT patients in Vancouver, Canada and the association with fentanyl exposure. Longitudinal data were derived from 804 participants on OAT enrolled in two community-recruited harmonized prospective cohort studies of people who use drugs in Vancouver between 2016 and 2018 via semi-annual interviews and urine drug screens (UDS). We employed multivariable generalized estimating equations to examine the relationship between OAT dissatisfaction and fentanyl exposure. Results Out of 804 participants (57.0% male), 222 (27.6%) reported being dissatisfied with OAT at baseline and 1070 out of 1930 observations (55.4%) had fentanyl exposure. The distribution of OAT reported in the sample was methadone (n = 692, 77.7%), buprenorphine-naloxone (n = 82, 9.2%), injectable OAT (i.e., diacetylmorphine or hydromorphone; (n = 65, 7.3%), slow-release oral morphine (n = 44, 4.9%) and other/study medication (n = 8, 1.0%). In the multivariable analysis, OAT dissatisfaction was positively associated with fentanyl exposure (AOR = 1.34; 95% CI: 1.08–1.66). Conclusions A substantial proportion of OAT patients in our sample reported dissatisfaction with their OAT, and more than half were exposed to fentanyl. We also found that those who were dissatisfied with their OAT were more likely to be exposed to fentanyl. These findings demonstrate the importance of optimizing OAT satisfaction in the context of the ongoing opioid overdose crisis.

Abstract The Antikythera Mechanism, an ancient Greek astronomical calculator, has challenged researchers since its discovery in 1901. Now split into 82 fragments, only a third of the original survives, including 30 corroded bronze gearwheels. Microfocus X-ray Computed Tomography (X-ray CT) in 2005 decoded the structure of the rear of the machine but the front remained largely unresolved. X-ray CT also revealed inscriptions describing the motions of the Sun, Moon and all five planets known in antiquity and how they were displayed at the front as an ancient Greek Cosmos. Inscriptions specifying complex planetary periods forced new thinking on the mechanization of this Cosmos, but no previous reconstruction has come close to matching the data. Our discoveries lead to a new model, satisfying and explaining the evidence. Solving this complex 3D puzzle reveals a creation of genius—combining cycles from Babylonian astronomy, mathematics from Plato’s Academy and ancient Greek astronomical theories.

The construct “parental psychological control” has been used to refer to those parental behaviors that interfere with the children’s thoughts and feelings. Examples of this type of behaviors would be inducing guilt or shame as well as the with-drawal of affection. The objective of this study was to validate and adapt the Spanish version of the Psychological Control Scale-Youth Self-Report (PCS-YSR) and the Psychological Control-Disrespect Scale (PCDS) and to analyze if the parental psychological control is defined as one dimension or two dimensions through manipulative and disrespectful behaviors towards adolescents. Also, the unique contribution of parental psychological control in predicting adolescent’s self-concept was examined. In two samples of undergraduate university students (the first, N = 367, mean age = 19.8, women=62.7%, men=37.3%, and the second, N= 312, mean age=19.7, women=73.9%, men=26.1%), exploratory and confirmatory factor analyses confirmed the hypothesized factor structure of the PCS-YSR and the PCDS, for both paternal and maternal ratings. Convergent validity was confirmed by consistent associations between both measures of parental psychological control and other measures of parental autonomy support and parental psychological control. The multi-group analysis confirmed that parental psychological control had a negative influence on self-concept. The results indicated that both scales are useful instruments for assessing parental psychological control.