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This paper describes creating and implementing a 30-h LGBTQIA+ specialty training for community health workers (CHWs). The training was co-developed by CHW training facilitators (themselves CHWs), researchers with expertise in LGBTQIA+ populations and health information, and a cohort of 11 LGBTQIA+ CHWs who theater tested and piloted the course. The research and training team collected cohort feedback through focus groups and an evaluative survey. Findings stress the importance of a curriculum designed to elicit lived experiences and informed by a pedagogical framework centered on achieving LGBTQIA+ visibilities. This training is a vital tool for CHWs to foster cultural humility for LGBTQIA+ populations and identify opportunities to support their health promotion, especially considering their limited and sometimes absent access to affirming and preventative healthcare. Future directions include revising the training content based on cohort feedback and adapting it to other contexts, such as cultural humility training for medical and nursing professionals and staff.

The following essays are part of a collaboration between theJournal of Law and ReligionandPolitical Theology.Editors from both journals selected the two texts interrogated and interpreted here—James Baldwin’s essay “Equal in Paris” and the United States Supreme Court decision in the caseUnited States v. Wong Kim Ark(1898). The purpose of the collaboration was twofold. The first purpose was to see what new interpretations arise when scholars working primarily in law read the essay by Baldwin, who has been a touchstone in much contemporary Black theology, and when scholars working in religious studies read the legal decision inWong Kim Ark, a case in which the Supreme Court extended citizenship to the child of Chinese immigrants who conceived and bore him on American soil. The second purpose was to divide publication between the journals, with each journal publishing three of the six essays, with a view to building bridges between readers of each journal over a topic at the intersection of both law and political theology.

Little is known about how varying the plane of nutrition before and after weaning can influence gene expression that drives mammary gland development (MGD). Therefore, the aim of this study was to investigate this paradigm in a seasonal sheep breed. Forty pre-weaning 30-day old Kurdish female lambs were fed either a low-nutrient and protein (L; 2.0 Mcal ME/kg DM; 8.70% crude protein [CP]) or high-nutrient and protein diet (H; 2.5 Mcal ME/kg DM; 14.80% CP). At d 120 (weaning), lambs were allocated into a 2 × 2 arrangement based on pre- and post-weaning diets, resulting in four groups (LL, LH, HL, HH). On d 210, mammary biopsy samples were taken for histomorphological and gene expression studies. Alveoli were larger in HH compared with all other groups (

IntroductionWomen with breast cancer who do not adhere to adjuvant endocrine therapy (AET) have increased risks of mortality and recurrence. There are multiple barriers to AET adherence, including medication side-effects, beliefs about medication, memory and psychological distress. We developed four intervention components, each targeting a different barrier. This pilot trial is part of the preparation phase of the Multiphase Optimisation Strategy, and aims to establish key trial parameters, establish intervention component adherence, establish availability and feasibility of outcome and process data, estimate variability in planned outcome measures and estimate cost of developing and delivering each intervention component.Methods and analysisThe four intervention components are as follows: short message service text reminders (target: memory); a written information leaflet (target: medication beliefs); a guided self-help Acceptance and Commitment Therapy programme (target: psychological flexibility to reduce distress) and a self-management website (target: side-effect management). To evaluate the feasibility of recruitment, acceptability of the intervention components and the availability of outcome data, we will conduct a multisite, exploratory pilot trial using a 24-1fractional factorial design, with a nested process evaluation. We will randomise 80 women with early-stage breast cancer who have been prescribed AET to one of eight experimental conditions. This will determine the combination of intervention components they receive, ranging from zero to four, with all conditions receiving usual care. Key outcomes of interest include medication adherence and quality of life. Progression to the optimisation phase will be based on predefined criteria for consent rates, patient adherence to intervention components and availability of medication adherence data.Ethics and disseminationThe study was reviewed by the Wales Research Authority Research Ethics Committee 3 (21/WA/0322). Written informed consent will be obtained from all patients before randomisation. The results of this trial will be disseminated in a peer-reviewed journal.Trial registration numberISRTCN10487576.

Accreting magnetic white dwarfs offer an opportunity to understand the interplay between spin-up and spin-down torques in binary systems. Monitoring of the white dwarf spin may reveal whether the white dwarf spin is currently in a state of near-equilibrium, or of uni-directional evolution towards longer or shorter periods, reflecting the recent history of the system and providing constraints for evolutionary models. This makes the monitoring of the spin history of magnetic white dwarfs of high interest. In this paper we report the results of a campaign of follow-up optical photometry to detect and track the 39 sec white dwarf spin pulses recently discovered in Hubble Space Telescope data of the cataclysmic variable V1460 Her. We find the spin pulsations to be present in g-band photometry at a typical amplitude of 0.4%. Under favourable observing conditions, the spin signal is detectable using 2-meter class telescopes. We measured pulse-arrival times for all our observations, which allowed us to derive a precise ephemeris for the white dwarf spin. We have also derived an orbital modulation correction that can be applied to the measurements. With our limited baseline of just over four years, we detect no evidence yet for spin-up or spin-down of the white dwarf, obtaining a lower limit of |P/Pdot|> 4e7 years, which is already 4 to 8 times longer than the timescales measured in two other cataclysmic variable systems containing rapidly rotating white dwarfs, AE Aqr and AR Sco., 8 pages, 6 figures. Accepted for publication in MNRAS

We use data from the COHERENT CsI[Na] scintillation detector to constrain sub-GeV leptophobic dark matter models. This detector was built to observe low-energy nuclear recoils from coherent elastic neutrino-nucleus scattering. These capabilities enable searches for dark matter particles produced at the Spallation Neutron Source mediated by a vector portal particle with masses between 2 and 400 MeV/c2. No evidence for dark matter is observed and a limit on the mediator coupling to quarks is placed. This constraint improves upon previous results by two orders of magnitude. This newly explored parameter space probes the region where the dark matter relic abundance is explained by leptophobic dark matter when the mediator mass is roughly twice the dark matter mass. COHERENT sets the best constraint on leptophobic dark matter at these masses.

AM CVn systems are ultra-compact, helium-rich, accreting binaries with degenerate or semi-degenerate donors. We report the discovery of five new eclipsing AM CVn systems with orbital periods of 61.5, 55.5, 53.3, 37.4, and 35.4 minutes. These systems were discovered by searching for deep eclipses in the Zwicky Transient Facility (ZTF) lightcurves of white dwarfs selected using Gaia parallaxes. We obtained phase-resolved spectroscopy to confirm that all systems are AM CVn binaries, and we obtained high-speed photometry to confirm the eclipse and characterize the systems. The spectra of two long-period systems (61.5 and 53.3 minutes) show many emission and absorption lines, indicating the presence of N, O, Na, Mg, Si, and Ca, and also the K and Zn, elements which have never been detected in AM CVn systems before. By modelling the high-speed photometry, we measured the mass and radius of the donor star, potentially constraining the evolutionary channel that formed these AM CVn systems. We determined that the average mass of the accreting white dwarf is $\approx0.8$$\mathrm{M_{\odot}}$, and that the white dwarfs in long-period systems are hotter than predicted by recently updated theoretical models. The donors have a high entropy and are a factor of $\approx$ 2 more massive compared to zero-entropy donors at the same orbital period. The large donor radius is most consistent with He-star progenitors, although the observed spectral features seem to contradict this. The discovery of 5 new eclipsing AM~CVn systems is consistent with the known observed AM CVn space density and estimated ZTF recovery efficiency. Based on this estimate, we expect to find another 1--4 eclipsing AM CVn systems as ZTF continues to obtain data. This will further increase our understanding of the population, but will require high precision data to better characterize these 5 systems and any new discoveries., Comment: submitted to MNRAS

BACKGROUND: The extravascular implantable cardioverter-defibrillator (ICD) has a single lead implanted substernally to enable pause-prevention pacing, antitachycardia pacing, and defibrillation energy similar to that of transvenous ICDs. The safety and efficacy of extravascular ICDs are not yet known. METHODS: We conducted a prospective, single-group, nonrandomized, premarket global clinical study involving patients with a class I or IIa indication for an ICD, all of whom received an extravascular ICD system. The primary efficacy end point was successful defibrillation at implantation. The efficacy objective would be met if the lower boundary of the one-sided 97.5% confidence interval for the percentage of patients with successful defibrillation was greater than 88%. The primary safety end point was freedom from major system- or procedure-related complications at 6 months. The safety objective would be met if the lower boundary of the one-sided 97.5% confidence interval for the percentage of patients free from such complications was greater than 79%. RESULTS: A total of 356 patients were enrolled, 316 of whom had an implantation attempt. Among the 302 patients in whom ventricular arrhythmia could be induced and who completed the defibrillation testing protocol, the percentage of patients with successful defibrillation was 98.7% (lower boundary of the one-sided 97.5% confidence interval [CI], 96.6%; P

AR Scorpii (AR Sco) is the only radio-pulsing white dwarf known to date. It shows a broad-band spectrum extending from radio to X-rays whose luminosity cannot be explained by thermal emission from the system components alone, and is instead explained through synchrotron emission powered by the spin-down of the white dwarf. We analysed NTT/ULTRACAM, TNT/ULTRASPEC, and GTC/HiPERCAM high-speed photometric data for AR Sco spanning almost seven years and obtained a precise estimate of the spin frequency derivative, now confirmed with 50-sigma significance. Using archival photometry, we show that the spin down rate of P/Pdot = 5.6e6 years has remained constant since 2005. As well as employing the method of pulse-arrival time fitting used for previous estimates, we also found a consistent value via traditional Fourier analysis for the first time. In addition, we obtained optical time-resolved spectra with WHT/ISIS and VLT/X-shooter. We performed modulated Doppler tomography for the first time for the system, finding evidence of emission modulated on the orbital period. We have also estimated the projected rotational velocity of the M-dwarf as a function of orbital period and found that it must be close to Roche lobe filling. Our findings provide further constraints for modelling this unique system., 15 pages, 18 figures. Accepted for publication in MNRAS

Some years back, around 2013, I was asked to write an article on the uses of the Bible in African law. Researching references to the Bible and biblical law across the African continent, I soon learned that, besides support for arguments by a few states in favor of declaring themselves “Christian nations,” the main use was in emerging debates over homosexuality and same-sex relationships—almost exclusively to condemn those relationships. In January 2013, the newly formed African Consortium for Law and Religion Studies (ACLARS) held its first international conference at the University of Ghana Legon. There, African sexuality debates emerged forcefully in consideration of a paper by Sylvia Tamale, then dean of the Makarere University School of Law in Uganda, who argued pointedly, “[P]olitical Christianity and Islam, especially, have constructed a discourse that suggests that sexuality is the key moral issue on the continent today, diverting attention from the real critical moral issues for the majority of Africans . . . . Employing religion, culture and the law to flag sexuality asthebiggest moral issue of our times and dislocating therealissue is a political act and must be recognised as such.”

Imperfections in analog-to-digital conversion (ADC) cannot be ignored when signal digitization requirements demand both wide dynamic range and high resolution, as is the case for the Majorana Demonstrator 76Ge neutrinoless double-beta decay search. Enabling the experiment’s high-resolution spectral analysis and efficient pulse shape discrimination required careful measurement and correction of ADC nonlinearities. A simple measurement protocol was developed that did not require sophisticated equipment or lengthy data-taking campaigns. A slope-dependent hysteresis was observed and characterized. A correction applied to digitized waveforms prior to signal processing reduced the differential and integral nonlinearities by an order of magnitude, eliminating these as dominant contributions to the systematic energy uncertainty at the double-beta decay $Q$ value.

Background Previous studies of decortication for empyema demonstrated that patient characteristics are associated with mortality, but the relationship of infectious pathogen to outcome has not been described. Our objective was to analyze the association of microbiology and antibiotic resistance with postoperative mortality after decortication for empyema. We hypothesized that bacterial pathogens, antibiotic resistance, and patient characteristics would all contribute to perioperative morbidity and mortality. Methods Patients undergoing pulmonary decortication for empyema from January 1, 2010 to October 1, 2017 were reviewed retrospectively. Cases were matched with microbiology cultures. Outcomes of interest were a composite of death, tracheostomy, initial ventilator support greater than 48 hours, or unexpected intensive care unit readmission. Antibiotic resistance was categorized as present or absent, and the number of antibiotics with resistance was counted for each patient. We describe the relationship of patient characteristics, antibiotic resistance, and microbiology to mortality. Results During the study period, 185 patients underwent decortication, 118 of whom had a diagnosis of primary empyema (63.8%). Positive culture results were present in 79 of 185 patients (43%). The most common isolate was Streptococcus, which was present in 29 of 79 (37%), followed by Staphylococcus in 19 of 79 (24%). Of 79 patients, 11 had fungal infections (13.9%). In addition, 16 of 79 patients had polymicrobial empyema (20%). Of 185 patients, 30 experienced the composite adverse outcome (16.2%). In multivariable regression, the composite adverse outcome was associated with emphysema, Candida in pleural culture, and antibiotic resistance count. Conclusions Perioperative mortality and morbidity after decortication for empyema is considerable. In this cohort, infections with increasing antibiotic resistance are associated with morbidity and mortality among patients with empyema.

We report a design methodology for creating high-performance photonic crystals with arbitrary geometric shapes. This design approach enables the inclusion of subwavelength shapes into the photonic crystal unit cell, synergistically combining metamaterials concepts with on-chip guided-wave photonics. Accordingly, we use the term “photonic metacrystal” to describe this class of photonic structures. Photonic metacrystals exploiting three different design freedoms are demonstrated experimentally. With these additional degrees of freedom in the design space, photonic metacrystals enable added control of light-matter interactions and hold the promise of significantly increasing temporal confinement in all-dielectric metamaterials.

This most comprehensive analysis to date of γδ T cells in the murine uterus reveals them to compose a unique local T-cell compartment. Consistent with earlier reports, most cells expressed a canonical Vγ6Vδ1 TCR, and produced interleukin (IL)-17A upon stimulation. Nonetheless, contrasting with earlier reports, uterine γδ T cells were not obviously intraepithelial, being more akin to sub-epithelial Vγ6Vδ1+ T cells at several other anatomical sites. By contrast to other tissues however, the uterine compartment also included non-Vγ6+, IFN-γ-producing cells; was strikingly enriched in young mice; expressed genes hitherto associated with the uterus, including the progesterone receptor; and did not require microbes for development and/or maintenance. This notwithstanding, γδ T-cell deficiency severely impaired resistance to reproductive tract infection by Candida albicans, associated with decreased responses of IL-17-dependent neutrophils. These findings emphasise tissue-specific complexities of different mucosal γδ cell compartments, and their evident importance in lymphoid stress-surveillance against barrier infection.

This study investigated the impacts of spent engine oil on the physicochemical properties of soil, soil's microbial population and growth of Capsicum annuum. It covered assessment of different levels of contamination (0, 20, 40, 60 and 80%) in soil; which represents the degree of oil spillage concentration on the growth performance of C. annuum investigated. Percentage germination, seedling height, number of leaves and number of branches decreased as the concentrations of the spent engine oil in soil samples increased and affected soil physicochemical properties. The screening experiment conducted showed that poultry manure improved the physicochemical properties of sandy loam soils contaminated engine oil. The effects of poultry manure as an organic amendment was assessed using pepper (C. annuum) as test crop. All amendment made significant increase in soil organic carbon and calcium content over the polluted soils. Soil acidity increased, soil exchangeable ions decreased. N, P and K were altered in the polluted soils as compared to the controls. There were increased bacterial counts (2.21 – 2.85) and a decrease in fungi population (0.48 - 0.59) in the spent engine oil-contaminated soils compared with the control. The oil reduced germination percentage, depressed growth, reduction in leaf number and plant height of the C. annuum. Therefore the spent engine oil clearly had detrimental effects on soil's physicochemical and biological properties. The oil contributed largely to the extreme acidic nature of the polluted soils. However, maximum increase in plant height, germination percentage, number of leaves and branches were recorded with amendment of the polluted soils with poultry manure. Results show the considerable potential of remediation protocols with poultry manure as a remediating agent for oil spill remediation in the soil samples.

The Majorana Demonstrator neutrinoless double-beta decay experiment comprises a 44 kg (30 kg enriched in ^{76}Ge) array of p-type, point-contact germanium detectors. With its unprecedented energy resolution and ultralow backgrounds, Majorana also searches for rare event signatures from beyond standard model physics in the low energy region below 100 keV. In this Letter, we test the continuous spontaneous localization (CSL) model, one of the mathematically well-motivated wave function collapse models aimed at solving the long-standing unresolved quantum mechanical measurement problem. While the CSL predicts the existence of a detectable radiation signature in the x-ray domain, we find no evidence of such radiation in the 19-100 keV range in a 37.5 kg-y enriched germanium exposure collected between December 31, 2015, and November 27, 2019, with the Demonstrator. We explored both the non-mass-proportional (n-m-p) and the mass-proportional (m-p) versions of the CSL with two different assumptions: that only the quasifree electrons can emit the x-ray radiation and that the nucleus can coherently emit an amplified radiation. In all cases, we set the most stringent upper limit to date for the white CSL model on the collapse rate, λ, providing a factor of 40-100 improvement in sensitivity over comparable searches. Our limit is the most stringent for large parts of the allowed parameter space. If the result is interpreted in terms of the Diòsi-Penrose gravitational wave function collapse model, the lower bound with a 95% confidence level is almost an order of magnitude improvement over the previous best limit.

Using photometric ULTRACAM observations of three new short period cataclysmic variables, we model the primary eclipse lightcurves to extract the orbital separation, masses, and radii of their component stars. We find donor masses of 0.060 +/- 0.008 solar masses, 0.042 +/- 0.001 solar masses, and 0.042 +/- 0.004 solar masses, two being very low-mass sub-stellar donors, and one within 2 sigma of the hydrogen burning limit. All three of the new systems lie close to the modified, "optimal" model evolutionary sequence of Knigge et al. (2011). We briefly re-evaluate the long-standing discrepancy between observed donor mass and radius data, and theoretical CV evolutionary tracks. By looking at the difference in the observed period at each mass and the period predicted by the Knigge et al. (2011) evolutionary sequence, we qualitatively examine the form of excess angular momentum loss that is missing from the models below the period gap. We show indications that the excess angular momentum loss missing from CV models grows in importance relative to gravitational losses as the period decreases. Detailed CV evolutionary models are necessary to draw more quantitative conclusions in the future., 17 pages, 14 figures, 5 tables

Background Adjuvant endocrine therapy (AET) reduces the risk of breast cancer recurrence and mortality. However, up to three-quarters of women with breast cancer do not take AET as prescribed. Existing interventions to support adherence to AET have largely been unsuccessful, and have not focused on the most salient barriers to adherence. This paper describes the process of developing four theory-based intervention components to support adherence to AET. Our aim is to provide an exemplar of intervention development using Intervention Mapping (IM) with guidance from the Multiphase Optimisation Strategy (MOST). Methods Iterative development followed the six-stage IM framework with stakeholder involvement. Stage 1 involved a literature review of barriers to adherence and existing interventions, which informed the intervention objectives outlined in Stage 2. Stage 3 identified relevant theoretical considerations and practical strategies for supporting adherence. Stage 4 used information from Stages 1-3 to develop the intervention components. Stages 5 and 6 detailed implementation considerations and evaluation plans for the intervention package, respectively. Results The final intervention package comprised four individual intervention components: Short Message Service to encourage habitual behaviours surrounding medication taking; an information leaflet to target unhelpful beliefs about AET; remotely delivered Acceptance and Commitment Therapy-based guided self-help to reduce psychological distress; and a website to support self-management of AET side-effects. Considerations for implementation within the NHS, including cost, timing and mode of delivery were outlined, with explanation as to how using MOST can aid this. We detail our plans for the final stage of IM which involve feasibility testing. This involved planning an external exploratory pilot trial using a 24−1 fractional factorial design, and a process evaluation to assess acceptability and fidelity of intervention components and overall trial experience. Conclusions We have described a systematic and logical approach for developing a theoretically informed intervention package to support medication adherence in women with breast cancer using AET. Further research to optimise the intervention package, guided by MOST, has the potential to lead to more effective, efficient and scalable interventions.