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Non-responsive celiac disease (NRCD) is defined as patients having persistent symptoms and enteropathy (Marsh 3 histology) suggestive of active celiac disease (CeD), after following a gluten-free diet (GFD) for at least 12 months. NRCD is suggested to affect 15% of children with CeD but data are limited and there is no research to date describing treatment of children with this condition. The aim of this study was to describe our center's approach to identifying and treating NRCD with budesonide and the Gluten Containing Elimination Diet (GCED).We performed a retrospective, single center analysis over a 5-year period of patients with CD less than 18 years of age (inclusive) who underwent treatment for persistent symptoms and enteropathy despite following a GFD.We identified 22 patients with NRCD. Thirteen were treated with the GCED for 3 months with 46% achieving both histological and symptomatic resolution. Nine patients were treated with budesonide (6-9 mg), with 89% achieving both symptomatic and histologic resolution after a median 3-month treatment course. Further, 67% of patients who responded to the GCED and 100% of patients who responded to budesonide remained in remission for at least 6 months following treatment transition back to exclusive GFD.The GCED and budesonide can provide benefit for NRCD. Most patients with NRCD can return to a GFD after 3 months of treatment.

International audience; Floods and heavy precipitation have disruptive impacts worldwide, but their historical variability remains only partially understood at the global scale. This article aims at reducing this knowledge gap by jointly analyzing seasonal maxima of streamflow and precipitation at more than 3,000 stations over a 100-year period. The analysis is based on Hidden Climate Indices (HCIs). Like standard climate indices (e.g., Nino 3.4, NAO), HCIs are used as covariates explaining the temporal variability of data, but unlike them, HCIs are estimated from the data. In this work, a distinction is made between common HCIs, that affect both heavy precipitation and floods, and specific HCIs, that exclusively affect one or the other. Overall, HCIs do not show noticeable autocorrelation, but some are affected by noticeable trends. In particular, strong and wide-ranging trends are identified in precipitation-specific HCIs, while trends affecting flood-specific HCIs are weaker and have more localized effects. A probabilistic model is then derived to link HCIs and large-scale atmospheric variables (pressure, wind, temperature) and to reconstruct HCIs since 1836 using the 20CRv3 reanalysis. In turn this allows estimating the probability of occurrence of floods and heavy precipitation at the global scale. This 180-year reconstruction highlights flood hot-spots and hot-moments in the distant past, well before the establishment of perennial monitoring networks. The approach presented in this study is generic and paves the way for an improved characterization of historical variability by making a better use of long but highly irregular station data sets.

Introduction: Health educators have had difficulty introducing health policy and public health training into an already intensive medical school curriculum. Although the COVID-19 pandemic may have changed perspectives on the importance of public health, it may not change educational approaches. Assessment of medical student opinions and perceptions of health policy and public health might influence the weight given to these topics in medical education. Methods: We used a 39-item instrument to cross-sectionally survey medical students, to assess their perceptions of the value of public health and health policy within their professional education. Results: One hundred two students completed the survey (13% response rate). Most students reported an interest in public health (94.1%) and health policy (92.2%). Although interested, most students lacked confidence in their knowledge of public health and health policy on both state (health policy 34.3% confident; public health 43.1%) and national (health policy 41.0%; public health 44.1%) levels. Most students perceived that their institution has not sufficiently prepared them to understand health policy (34% felt prepared) and most reported insufficient information to participate in policy discussions (30.3% sufficiently informed). Conclusions: Medical students reported an interest in public health and health policy while also reporting a lack of confidence in their level of preparedness to understand and participate in these fields, thus demonstrating a need for increased public health and health policy education within medical school curricula.

Temperature, particularly within ~1 month of egg laying, is thought to be an important, short-term cue used by female birds to calibrate timing of breeding to local conditions. Here, we show that a relatively broad, long-term, temperature window (January 2 to April 4, 92 days; r2 = 0.73) best predicted timing of egg laying in European Starlings (Sturnus vulgaris). A “mid-winter” temperature window was also strongly correlated with laying date (r2 = 0.58), but we found no support for an influence of short-term temperatures immediately before egg laying. We assessed the relationship between ambient temperature and timing of egg laying using three complimentary approaches: (1) an “unconstrained,” exploratory analysis; (2) a traditional sliding window approach; and (3) specific, biologically informed temperature windows. Our results contrast with the widely held view that short-term, prebreeding temperatures best predict variation in laying because they allow birds to adjust timing of breeding to local conditions around the time of egg laying. This means that mechanisms that allow integration of long-term temperature information must exist in birds—perhaps most parsimoniously involving indirect effects of temperature on growth of the bird’s ectothermic insect prey—even though these are currently poorly characterized.

Treating SEL as a typical curriculum implementation or school improvement initiative is problematic because it suggests that there are discrete SEL programs or tactics that can be put into place, regardless of school context or professional culture, to advance student outcomes. Such SEL initiatives risk not only failing to achieve the desired beneficial outcomes for students, but also overburdening or alienating educators. Those who want positive SEL outcomes must fully attend to supporting teacher learning. In this chapter, the authors describe the ways that SEL-related teacher professional development is currently enacted in U.S. P-12 school settings, critique current practices in light of what is known about effective professional development, and showcase a unique and replicable approach to SEL currently being enacted in an urban district in the northeast United States that led to positive social-emotional learning outcomes.

Plasmodium falciparum (Pf) is the dominant malaria parasite in Nigeria though P. vivax (Pv), P. ovale (Po), and P. malariae (Pm) are also endemic. Blood samples (n = 31,234) were collected from children aged 0-14 years during a 2018 nationwide HIV survey and assayed for Plasmodium antigenemia, Plasmodium DNA, and IgG against Plasmodium MSP1-19 antigens. Of all children, 6.6% were estimated to have Pm infection and 1.4% Po infection with no Pv infections detected. The highest household wealth quintile was strongly protective against infection with Pm (aOR: 0.11, 95% CI: 0.05–0.22) or Po (aOR= 0.01, 0.00–0.10). Overall Pm seroprevalence was 34.2% (95% CI: 33.3-35.2) with lower estimates for Po (12.1%, 11.6-12.5) and Pv (6.3%, 6.0-6.7). Pm seropositivity was detected throughout the country with several local government areas showing >50% seroprevalence. Serological and DNA indicators show widespread exposure of Nigerian children to Pm with lower rates to Po and Pv.

The objective was to evaluate the impact of sow location, within farrowing room, on reproduction during periods of heat stress. Data were collected on 1,866 sows at a 3,600-sow commercial farm in eastern North Carolina from May to August 2021. In the farrowing buildings, evaporative cool cell pads cooled the air entering the hallway. Cooled air, from the hallway, then entered the farrowing rooms through inlets at the front of the room and was pulled through the room by fans in the back of the farrowing room. For data analysis, each farrowing room was divided into four zones. Zone 1 included the sows at the front of the farrowing room near the inlets letting in cooled air. Zone 4 included sows at the back of the room where air exited the building through fans embedded within the wall. Zones 2 and 3 were intermediate. Each farrowing room on the farm housed between 18 and 36 sows. After farrowing, sows had ad libitum access to the lactation diet. Traits included piglet survival (number weaned ÷ total number born) the percentage of sows conceiving by 7 days after weaning, subsequent total number born, subsequent number born alive, subsequent stillborns, sow caliper score prefarrow, sow caliper score at weaning and sow caliper lactation loss. Results are shown in Table 1. Piglet survival was greater (P < 0.05) for sows that farrowed at the front of the room near the cool air inlets. Similarly, litter weaning weight was heavier (P < 0.05) near the cool air inlets relative to the back part of the farrowing room. The percentage of sows that conceived by 7 days after weaning, and farrowed, was linearly associated (P < 0.05) with farrowing zone. Sows near the cool air inlets lost less (P < 0.05) body condition and farrowed more (P < 0.05) piglets in the subsequent litter relative to sows in the back of the farrowing room. Results showed sows that farrowed at the front of the farrowing room lost less body condition, had greater piglet survival, heavier litter weaning weights and were more likely to be rebred and conceive by 7 days after weaning relative to sows farrowing in the back of the farrowing room.

Heat stress has negative impacts on pork production, particularly during the grow-finish phase. During heat stress events, swine alter feeding behavior to reduce heat production, which can negatively affect performance. Recent technology advancements in feed management systems allow for individualized data recording of feeding behavior for group housed pigs during the finishing phase. The objective of this study was to utilize an RFID-based feed management system to determine feeding behavior patterns of finishing pigs during heat stress conditions and identify changes in behavior due to heat stress events. Data included one pen of 29 Duroc boars reared in a mechanically ventilated facility in north central North Carolina. Feed Intake Recording Equipment (FIRE) pig feeders (n = 3; Osborne Technologies) fed individual pigs in the group housed setting using RFID technology and recorded the number of visits, feed intake of each visit, visit duration, and body weight of each pig during each visit. Feeders were calibrated once per week to ensure accuracy of feed intake and body weight measurements. On day 1 of the study, pigs were placed in the experimental pen and body weights were recorded (37.4 kg ± 4.9 kg) using the FIRE feeders. Air temperature, humidity, and dew point data were collected continuously every 5 minutes from day 13 until the end of the finishing period. Pigs exited finishing (134.5 ± 8.6 kg) on day 83. Feeding behavior traits (number of visits and feed intake) were summarized by day. Temperature, humidity, and heat index were summarized by a maximum, minimum, and mean value for each day. Average temperature, humidity, feeder visits a day, and average daily feed intake across the trial was 26.3 ± 1.6 º C, 75.8 ± 6.7%, 6.1 ± 1.0 visits, 2.66 ± 0.39 kg. Models were used to associate feeding behavior traits with the quadratic effects of day and the linear effects of average temperature and humidity and the interaction of temperature and humidity. Temperature and humidity were associated (P < 0.01) number of feeder visits and average daily intake per day. Further, there was an interaction (P < 0.01) between temperature and humidity in relation to number of feeder visits and average daily feed intake. Results suggest substantial variation in feeding behaviors can be explained by temperature and humidity.

Pig manure contains a wide variety of corrosion-inducing chemicals such as ammonia. Ammonia production and its release are influenced by temperature and moisture in the barn environment. Increased concentrations of ammonia can negatively affect pig health and growth, as well as pose a risk to human health. Additionally, even at decreased concentrations, ammonia reacts with humidity and causes premature corrosion of barn equipment and is a threat to the structural integrity of livestock buildings. In this study, ammonia concentrations were monitored and compared between two 880 head wean-finish swine facilities with different types of waste management systems. Both facilities had shallow manure pits, one containing a flush system and one containing a pull plug system to remove manure from the barns into the lagoon. Ammonia, dry-bulb air temperature, and relative humidity levels were measured every0 min for an entire wean-finish cycle (approximately 20 weeks). Data will be compared between the facilities to evaluate the impact of the waste management systems on indoor air quality conditions. Potential implications for pig health and growth and facility maintenance will be explored. Results will provide information on best management strategies for swine facilities.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) now known as COVID-19 changed the world and the outdoor adventure and experiential education (OAEE) fields were not immune. These changes significantly impacted various OAEE programs in multiple ways and at different levels of intensity. Purpose: The purpose of this study was to ascertain the impacts of the COVID-19 pandemic on the OAEE fields and identify how OAEE organizations have responded to those impacts. Methodology/Approach: Using a three-phase study and a multi-method approach to data collection and analyses, respondents from 115 OAEE organizations (N=115) were asked to indicate how and in what ways their organizations have been impacted by the pandemic and in what ways their organizations have responded to those challenges. Findings/Conclusions: Many organizations responded not being ready for the impacts from the COVID-19 pandemic. Significant impacts were noted from most of the OAEE organizations responding and included closings, staff reductions, and downsizing as well as operational changes. Many organizations reported ways they are attempting to mitigate the pandemic effects. Implications: Important questions were raised in this paper as to how well prepared the OAEE fields might be for the next crisis.

Iron-based catalysts are a preferred variant of metal catalysts due to the high abundance of iron on earth. Iron carbide has been investigated in recent times as an electrochemical catalyst due to its potential as a great ORR catalyst. Using a unique amine-metal complex anion composite (AMAC) method, iron carbide/nitride nanoparticles (Fe3C and Fe3−x N) were synthesized through varying several reaction parameters. While the synthesis is generally quite robust and can easily afford phase pure Fe3C, it now has been shown that the particle size, morphology, excess carbon, and amount of nitrogen in the resulting nanomaterials can readily be tuned. In addition, it was discovered that Fe2N can be synthesized as an intermediate by stopping the reaction at a lower heating temperature. These nanomaterials were tested for their electrochemical activity in oxygen evolution reactions (OER).