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Abstract The record-breaking temperatures in Europe during the 2022 summer were associated with over 60,000 heat-related deaths. By combining epidemiological models with detection and attribution techniques, we attribute half of this mortality burden (~56% [95% CI 39–77%]) to anthropogenic warming. Likewise, this applies to all sexes, ages, and heat-related mortality burdens during previous years (2015–2021). Our results urgently call for increasing ambition in adaptation and mitigation.

Abstract Human-wildlife interactions are situated within dynamic systems, characterized by social and ecological complexity. Human-wildlife coexistence research, however, typically focuses on one component of these systems in isolation. We inadvertently followed this norm while carrying out semi-structured interviews of livestock-owners in Northern Tanzania. As existing literature highlighted that this area was a hotspot for livestock depredation, our research questions focused on human interactions with carnivores. Interestingly, almost three quarters (72%, n = 72 of 100) of study participants independently raised African elephants (Loxodonta africana) as presenting the greatest impediments to coexistence. By centering our interviews on carnivores, we omitted vital components of this complex system. To counteract the effects of this oversimplification, we changed our intended analytical process after data collection. Instead of conducting a quantitative analysis of rates of livestock depredation and perceptions of risk posed by a suite of sympatric carnivores, we applied a grounded theory approach to assess interactions across multiple dimensions of this complex system. Through this transparent effort to realign our approaches with the complexity of the study system, we highlight the importance of designing research approaches that effectively reflect the complexities inherent to human-wildlife coexistence.

Free-space optical communications in the mid-infrared transparency windows (4–5 and 8–14 μm wavelength regions) is emerging as a viable solution for high bitrate data transmission. Unipolar quantum optoelectronics is the technology of choice for data communication in this wavelength region, thanks to the high frequency response of detectors and modulators. In this work, it is demonstrated that the performances of these devices can be substantially enhanced by embedding them into metamaterials. It is also shown that metamaterials have to be engineered differently in detectors than in modulators, as the role of light–matter interaction must be tuned adequately in the two devices. Metamaterial-enhanced performances allow the realization of data transmission with a record rate of 68 Gbit/s, while ensuring robustness and consistency, as it should be for real-world applications. These findings underscore the promising role of metamaterial-enhanced unipolar devices in advancing free-space optical communication systems.

Background: Current segmentation approaches for radiation treatment planning in head and neck cancer patients (HNCP) typically consider the entire mandible as an organ at risk, whereas segmentation of the maxilla remains uncommon. Accurate risk assessment for osteoradionecrosis (ORN) or implant-based dental rehabilitation after radiation therapy may require a nuanced analysis of dose distribution in specific mandibular and maxillary segments. Manual segmentation is time-consuming and inconsistent, and there is no definition of jaw subsections. Materials and methods: The mandible and maxilla were divided into 12 substructures. The model was developed from 82 computed tomography (CT) scans of HNCP and adopts an encoder-decoder three-dimensional (3D) U-Net structure. The efficiency and accuracy of the automated method were compared against manual segmentation on an additional set of 20 independent CT scans. The evaluation metrics used were the Dice similarity coefficient (DSC), 95% Hausdorff distance (HD95), and surface DSC (sDSC). Results: Automated segmentations were performed in a median of 86 s, compared to manual segmentations, which took a median of 53.5 min. The median DSC per substructure ranged from 0.81 to 0.91, and the median HD95 ranged from 1.61 to 4.22. The number of artifacts did not affect these scores. The maxillary substructures showed lower metrics than the mandibular substructures. Conclusions: The jaw substructure segmentation demonstrated high accuracy, time efficiency, and promising results in CT scans with and without metal artifacts. This novel model could provide further investigation into dose relationships with ORN or dental implant failure in normal tissue complication prediction models.

Background: Traumatic brain injuries (TBIs) are a common consequence of experiencing intimate partner violence (IPV). IPV-related TBI contributes to adverse health outcomes among women, but it is unknown whether a history of IPV-related TBI negatively impacts safety outcomes following healthcare-based interventions for IPV. Methods: Using data from a larger randomized clinical trial, we explored the impact of IPV-related TBI status on safety-related outcomes in two healthcare-based IPV interventions. At baseline, 35% (n = 21) of the sample screened positive for IPV-related TBI history. We used repeated measures ANOVAs to examine differences in safety outcomes at post-treatment and 1-month follow-up based on treatment condition and IPV-related TBI status. Results: Significant interaction effects were found for safety outcomes, such that women with IPV-related TBI history experienced larger reductions in the frequency of physical IPV and similar reductions in sexual IPV across both treatment conditions compared to women without IPV-TBI (F(2, 102) = 10.88, p < 0.001; F(2, 98) = 3.93, p = 0.036). Conclusions: Findings suggest that brief healthcare-based IPV interventions may result in improvements in safety outcomes for women with a history of IPV-TBI. This highlights the continued need for implementation of promising IPV-focused interventions to promote safety and protect women from experiencing further IPV.

Abstract Connecting chemical properties to various wine characteristics is of great interest to the science of olfaction as well as the wine industry. We explored whether Bordeaux wine chemical identities and vintages (harvest year) can be inferred from a common and affordable chemical analysis, namely, a combination of gas chromatography (GC) and electron ionization mass spectrometry. Using 12 vintages (within the 1990–2007 range) from 7 estates of the Bordeaux region, we report that, remarkably, nonlinear dimensionality reduction techniques applied to raw gas chromatograms recover the geography of the Bordeaux region. Using machine learning, we found that we can not only recover the estate perfectly from gas chromatograms, but also the vintage with up to 50% accuracy. Interestingly, we observed that the entire chromatogram is informative with respect to geographic location and age, thus suggesting that the chemical identity of a wine is not defined by just a few molecules but is distributed over a large chemical spectrum. This study demonstrates the remarkable potential of GC analysis to explore fundamental questions about the origin and age of wine.

Abstract Exposure to e-cigarette vapors alters important biologic processes including phagocytosis, lipid metabolism, and cytokine activity in the airways and alveolar spaces. Little is known about the biologic mechanisms underpinning the conversion to e-cigarette, or vaping, product use-associated lung injury (EVALI) from normal e-cigarette use in otherwise healthy individuals. We compared cell populations and inflammatory immune populations from bronchoalveolar lavage fluid in individuals with EVALI to e-cigarette users without respiratory disease and healthy controls and found that e-cigarette users with EVALI demonstrate a neutrophilic inflammation with alveolar macrophages skewed towards inflammatory (M1) phenotype and cytokine profile. Comparatively, e-cigarette users without EVALI demonstrate lower inflammatory cytokine production and express features associated with a reparative (M2) phenotype. These data indicate macrophage-specific changes are occurring in e-cigarette users who develop EVALI.

Abstract Background Despite a publicly-funded healthcare system, alarming cancer-related health and healthcare inequities persist in Canada. However, it remains unclear how equity is being understood and taken up within the Canadian cancer context. Our objective was to identify how health and healthcare equity are being discussed as goals or aims within the cancer care sector in Canada. Methods A rapid scoping review was conducted; five biomedical databases, 30 multidisciplinary websites, and Google were searched. We included English-language documents published between 2008 and 2021 that discussed health or healthcare equity in the Canadian cancer context. Results Of 3860 identified documents, 83 were included for full-text analysis. The prevalence of published and grey equity-oriented literature has increased over time (2008-2014 [n = 20]; 2015-2021 [n = 62]). Only 25% of documents (n = 21) included a definition of health equity. Concepts such as inequity, inequality and disparity were frequently used interchangeably, resulting in conceptual muddling. Only 43% of documents (n = 36) included an explicit health equity goal. Although a suite of actions were described across the cancer control continuum to address equity goals, most were framed as recommendations rather than direct interventions. Conclusion Health and healthcare equity is a growing priority in the cancer care sector; however, conceptual clarity is needed to guide the development of robust equity goals, and the development of sustainable, measurable actions that redress inequities across the cancer control continuum. If we are to advance health and healthcare equity in the cancer care sector, a coordinated and integrated approach will be required to enact transformative and meaningful change.

Animal hoarding and human consumption by dogs have been important but often understudied aspects of the human-animal bond that can be addressed within a One Health framework. No scientific report has focused on dog scavenging on animal hoarders to date, despite isolated reports of dog scavenging on human remains, mostly due to starvation. The phenomenon has been approached as a confounding factor for human forensics. In 2014, the Animal Protection Department of Curitiba City was called to rescue and handle ten small dogs which had scavenged for a week on the human remains of their elderly owner, a potential animal hoarder. At inspection, three dead dogs in early putrefaction were also found in the household. Human autopsy revealed body putrefaction and lack of soft organs. Along with the dental arch, DNA testing was performed on the remains for official deceased identification. Due to the potential public health risks of aggression toward frail human beings and for the control of zoonotic diseases, all ten dogs were euthanized. Subsequent investigations by the crime scene police, homicide police, and autopsy services were unable to establish or rule out natural death, criminal or suicidal poisoning, zoonotic disease (rabies), fatal dog attack, or fatal accidental trauma. A general protocol has been proposed for future approaches to dog scavenging and suspicious killing of animal hoarders, as well an assessment for the potential adoption or euthanasia of animals owned by hoarders in these circumstances.

EEG alpha power varies under many circumstances requiring visual attention. However, mounting evidence indicates that alpha may not only serve visual processing, but also the processing of stimuli presented in other sensory modalities, including hearing. We previously showed that alpha dynamics during an auditory task vary as a function of competition from the visual modality (Clements et al., 2022) suggesting that alpha may be engaged in multimodal processing. Here we assessed the impact of allocating attention to the visual or auditory modality on alpha dynamics at parietal and occipital electrodes, during the preparatory period of a cued-conflict task. In this task, bimodal precues indicated the modality (vision, hearing) relevant to a subsequent reaction stimulus, allowing us to assess alpha during modality-specific preparation and while switching between modalities. Alpha suppression following the precue occurred in all conditions, indicating that it may reflect general preparatory mechanisms. However, we observed a switch effect when preparing to attend to the auditory modality, in which greater alpha suppression was elicited when switching to the auditory modality compared to repeating. No switch effect was evident when preparing to attend to visual information (although robust suppression did occur in both conditions). In addition, waning alpha suppression preceded error trials, irrespective of sensory modality. These findings indicate that alpha can be used to monitor the level of preparatory attention to process both visual and auditory information, and support the emerging view that alpha band activity may index a general attention control mechanism used across modalities.

From 2017 to 2019, an extensive sampling campaign was conducted in Belgian inland and coastal waters, aimed at providing paired data of optical and biogeochemical properties to support research into optical monitoring of aquatic systems. The campaign was focused on inland waters, with sampling of four lakes and a coastal lagoon during the growth season, in addition to samples of opportunity from other four lakes. Campaigns also included the Scheldt estuary over a tidal cycle and two sampling campaigns in the Belgian coastal zone. Measured parameters include inherent optical properties (absorption, scattering and beam attenuation coefficients, near-forward volume scattering function, turbidity), apparent optical properties (Secchi disc depth, substrate and water-leaving Lambert-equivalent bi-hemispherical reflectance), and biogeochemical properties (suspended particulate matter, mineral fraction of particle mass, particle size distribution, pigment concentration, DNA metabarcoding, flow microscopy counts, and bottom type classification). The diversity of water bodies and environmental conditions covered a wide range of system states. The chlorophyll a concentration varied from 0.63 to 382.72 mg m−3, while the suspended particulate matter concentration varied from 1.02 to 791.19 g m−3, with mineral fraction varying from 0 to 0.95. Depending on system and season, phytoplankton assemblages were dominated by cyanobacteria, green algae (Mamiellophyceae, Pyramimonadophyceae), or diatoms. The dataset is available from https://doi.org/10.1594/PANGAEA.940240 (Castagna et al., 2022).

The purpose of this study was to capture the perceptions of COVID-19 mitigations’ efficacy of rural and non-rural participants, using the health belief model (HBM), as well as to describe where public health nursing may be able to fill behavior gaps in rural communities. Rural and non-rural participants completed electronic surveys. Surveys collected demographic information and perceptions of various mitigation strategies’ effectiveness. Rurality was significantly associated with perceptions of the effectiveness of public health mitigation strategies including wearing facemasks, limiting time indoors, avoiding gatherings, non-essential business closure, and staying home. Our findings suggest people in rural areas perceive mitigations to be effective. Other researchers have consistently shown rural residents are least likely to partake in the same mitigations. Rural public health nurses on the front line serve as the key to closing the aforementioned gap. Understanding where their community’s perceptions lie is pivotal in creating educational programs to continue mitigation efforts as we embark on the second year of this pandemic.

Transboundary livestock diseases are a high priority for policy makers because of the serious economic burdens associated with infection. In order to make well informed preparedness and response plans, policy makers often utilize mathematical models to understand possible outcomes of different control strategies and outbreak scenarios. Many of these models focus on the transmission between herds and the overall trajectory of the outbreak. While the course of infection within herds has not been the focus of the majority of models, a thorough understanding of within-herd dynamics can provide valuable insight into a disease system by providing information on herd-level biological properties of the infection, which can be used to inform decision making in both endemic and outbreak settings and to inform larger between-herd models. In this study, we develop three stochastic simulation models to study within-herd foot and mouth disease dynamics and the implications of different empirical data-based assumptions about the timing of the onset of infectiousness and clinical signs. We also study the influence of herd size and the proportion of the herd that is initially infected on the outcome of the infection. We find that increasing herd size increases the duration of infectiousness and that the size of the herd plays a more significant role in determining this duration than the number of initially infected cattle in that herd. We also find that the assumptions made regarding the onset of infectiousness and clinical signs, which are based on contradictory empirical findings, can result in the predictions about when infection would be detectable differing by several days. Therefore, the disease progression used to characterize the course of infection in a single bovine host could have significant implications for determining when herds can be detected and subsequently controlled; the timing of which could influence the overall predicted trajectory of outbreaks.

Abstract The field and study of human-animal interaction (HAI) have experienced substantial and ongoing growth in scientific rigor and, public awareness. Yet, considerations for the role of diversity in the field have thus far remained limited, and efforts to promote diversity, equity, and inclusion (DEI) in HAI are critically needed. As one of the first steps to improving DEI is to conduct a baseline assessment, the present study sought to address two questions: (1) what is the representativeness among field leaders (i.e. directors of HAI research and education centers)? and (2) what are their perceptions about the status and importance of DEI in the field? Surveys were completed by Human-Animal Bond (HAB) center representatives and directors regarding center and director demographics, and perceived importance of DEI and diversity among professionals and clients in the field. Themes from DEI-focused discussions with expert panels at the 2021 CHAB Conference, were used to interpret and frame the implications of these survey results and make recommendations for the next steps to actively promote and support DEI in HAI. Results indicated racial homogeneity among center directors, with some limited representativeness in other facets of diversity (e.g. sexual orientation, disability, religion). There was limited perceived diversity among field professionals and the communities served, but high perceived importance of diversity in the HAI field. Finally, results suggested inconsistencies in the understanding of barriers to DEI in HAI and a lack of knowledge about strategies for promoting DEI in the field. This manuscript provides a summary of current DEI in the field along with existing resources and guidelines from DEI experts.

Abstract Hypophosphatasia (HPP) is an underrecognized, complex bone mineralization disorder with variable manifestations caused by one or two deleterious variants in the alkaline phosphatase (ALPL) gene. Expanded carrier screening (ECS), inclusive of ALPL, intends to inform reproductive risk but may incidentally reveal an HPP diagnosis with 50% familial risks. We sought to investigate at‐risk individuals and develop a multidisciplinary referral and evaluation protocol for ECS‐identified ALPL heterozygosity. A retrospective database query of ECS results from 8 years to 1 month for heterozygous pathogenic/likely pathogenic ALPL variants was completed. We implemented a clinical protocol for diagnostic testing and imaging, counseling, and interdisciplinary care management for identified patients, and outcomes were documented. Heterozygous ALPL variants were identified in 12/2248 unrelated patients undergoing ECS (0.53%; heterozygote frequency 1/187). Of 10 individuals successfully contacted, all demonstrated symptomatology and/or alkaline phosphatase values consistent with HPP. ECS may reveal incidental health risks, including recognition of missed HPP diagnoses in ALPL heterozygotes. In our cohort, all ECS‐identified ALPL heterozygotes with clinical and/or biochemical data available demonstrated features of HPP. Referral to a genetics professional familiar with HPP is indicated for family history assessment, genetic counseling, cascade testing, and long‐term bone health management.

SUMMARY: A study was conducted to investigate the effect of blue and red light-emitting diode (LED) on performance, behavior, egg quality, and hormonal concentration of pullets and laying hens. A total of 1,000 Hy-Line W-36 birds were raised in a cage-free housing system consisting of two identical rooms, one equipped with blue-LED from 1 to 18 wk of age and red-LED from 19 to 31 wk of age, and the other with normal-LED bulbs throughout the study. The study was repeated the following year. Body weight was recorded monthly, and egg production was recorded daily. Egg quality, organ weight, tonic immobility (TI), heterophil-lymphocyte ratio, serum corticosterone, luteinizing hormone and melatonin were analyzed monthly after the egg production started. The results showed that birds raised in blue-LED had a significantly higher body weight during the pullet phase from 1 to 18 wk of age (P = 0.049). A higher relative egg yolk percentage was observed in the red-LED (P = 0.043) with a lower relative albumen percentage (P = 0.015) compared to the normal-LED light. Lower relative spleen weight was observed in the red-LED compared to the normal-LED (P = 0.027). There was no difference between the light treatments with respect to hen day egg production, brain weight, tonic immobility and hormone concentration. The effects of these lights on the overall production, health, and immune system are not completely understood. Hence, it is difficult to conclude that exposing birds to blue-LED in the pullet phase for improved growth and red-LED in the laying phase for earlier and greater egg production would benefit overall egg production.

The IL-17A inhibitor secukinumab is efficacious for the treatment of psoriasis. To better understand its mechanism of action, we investigated its impact on psoriatic lesions from 15 patients with moderate-to-severe plaque psoriasis undergoing secukinumab treatment. We characterized the longitudinal transcriptomic changes of whole lesional skin tissue as well as cutaneous CD4+ and CD8+ T effector cells and CD4+ T regulatory cells across 12 weeks of treatment. Secukinumab was clinically effective and reduced disease-associated overexpression of IL17A, IL17F, IL23A, IL23R, and IFNG in whole tissue as soon as 2 weeks after initiation of treatment. IL17A overexpression in T-cell subsets, primarily CD8+ T cells, was also reduced. Although secukinumab treatment resolved 89‒97% of psoriasis-associated expression differences in bulk tissue and T-cell subsets by week 12 of treatment, we observed expression differences involved in IFN signaling and metallothionein synthesis that remained unresolved at this time point as well as potential treatment-associated expression differences involved in IL-15 signaling. These changes were accompanied by shifts in broader immune cell composition on the basis of deconvolution of RNA-sequencing data. In conclusion, our study reveals several phenotypic and cellular changes within the lesion that underlie clinical improvement from secukinumab.

BackgroundMost external peripheral nerve stimulation devices designed to alter mood states use electrical energy, but mechanical stimulation for activation of somatosensory pathways may be harnessed for potential therapeutic neuromodulation. A novel investigational device for Mechanical Affective Touch Therapy (MATT) was created to stimulate C-tactile fibers through gentle vibrations delivered by piezoelectric actuators on the bilateral mastoid processes.Methods22 adults with anxiety disorders and at least moderate anxiety symptom severity enrolled in an open-label pilot trial that involved MATT self-administration using a simple headset at home at least twice per day for 4 weeks. Resting EEG data were acquired before and after a baseline MATT session and again before the final MATT session. Self-report measures of mood and anxiety were collected at baseline, week 2, and week 4, while interoception was assessed pre- and post-treatment.ResultsAnxiety and depressive symptoms improved significantly from baseline to endpoint, and mindfulness was enhanced. EEG metrics confirmed an association between acute MATT stimulation and oscillatory power in alpha and theta bands; symptom changes correlated with changes in some metrics.ConclusionOpen-label data suggest MATT is a promising non-invasive therapeutic approach to anxiety disorders that warrants further development.

BackgroundRevisits within 30 days to an emergency department (ED), observation care unit, or inpatient setting following patient discharge continue to be a challenge, especially in urban settings. In addition to the consequences for the patient, these revisits have a negative impact on a health system’s finances in a value-based care or global budget environment. LifeBridge Health, a community health system in Maryland, United States, implemented an automated mobile patient engagement application as part of our enterprise-wide digital health strategy to improve patient engagement and reduce revisits to the ED. ObjectiveThe aim of this paper was to evaluate the effectiveness of a customized automated digital patient engagement application (GetWell Loop) to reduce 30-day revisits after home discharge from an ED. MethodsThe LifeBridge Health Innovation Department and ED staff from 2 participating health system hospitals collaborated with GetWellNetwork to customize their patient engagement application with automated check-in questions and other on-demand resources (eg, streaming content explaining aspects of self-care during COVID-19). An application link was emailed to adult patients discharged home from the ED. A study of ED visits for patients treated for general medicine and cardiology conditions between August 1, 2018, and July 31, 2019, was conducted using CRISP (Chesapeake Regional Information System for our Patients), Maryland’s state-designated health information exchange. We also used data within GetWell Loop (GetWellNetwork) to track patient activation and engagement. The primary outcome was the number of ED patients who experienced a 30-day revisit and who did or did not activate their GetWell Loop account. Secondary outcomes included the overall activation rate and the rate of engagement as measured by the number of logins, alerts, and comments generated by patients through the application. Bivariate analysis comparing outcomes among patients who activated the GetWell Loop application to patients who did not was conducted using the Fisher exact test. Multivariate logistic regression modeling with elastic net regularization was also performed to account for potential confounders and potential collinearity of covariates. ResultsDuring this 1-year study, 1062 (27.4%) of 3866 of all emergency patients treated for general medicine or cardiology conditions, who received an invite to use the digital application, activated their account. The patients discharged from the ED, who were treated for general medicine conditions (n=2087) and who activated their GetWell Loop account, experienced a 30-day revisit rate of 17.3% (n=101) compared with 24.6% (n=369) for those who did not activate their account (P