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Inequality represents an extreme environment to which humans must respond. One phenomenon that contributes to this growing extreme is precarity or the intersection of uncertainty and some form of inequality. While precarity has an important intellectual history in the fields of sociology and sociocultural anthropology, it has not been well studied in the field of human biology. Rather human biologists have engaged with the study of closely related concepts such as uncertainty and resource insecurity. In this article, we propose that human biology take on the study of precarity as a novel way of investigating inequality. We first provide a brief intellectual history of precarity which is followed by a review of research on uncertainty and resource security in human biology which, while not exhaustive, illustrates some key gaps that precarity may aid us in addressing. We then review some of the pathways through which precarity comes to affect human biology and health and some of the evidence for why the unpredictable nature of precarity may make it a unique physiological stress. A case study based on research in Nuñoa, Peru provides an important example of how precarity can elucidate the influences of health in an extreme setting, albeit with insights that apply more broadly. We conclude that precarity holds important potential for the study of human biology, including helping us more effectively operationalize and study uncertainty, encouraging us to explore the predictability of resources and stressors, and reminding us to think about the intersectional nature of stressors. [ABSTRACT FROM AUTHOR]

Autophagy is a vital cellular process, essential to maintaining cellular function during acute physiological stressors including exercise and heat stress. We previously showed that autophagy occurs during exercise in an intensity-dependent manner in peripheral blood mononuclear cells (PBMCs) from young men, with elevated responses in the heat. However, given autophagy declines with age, it is unclear whether a similar pattern of response occurs in older adults. Therefore, we evaluated autophagy and the cellular stress response [i.e., apoptosis, inflammation, and the heat shock response (HSR)] in PBMCs from 10 healthy older men [mean (SD): aged 70 yr (5)] in response to 30 min of semirecumbent cycling at low, moderate, and vigorous intensities [40, 55, and 70% maximal oxygen consumption (Vo2max), respectively] in a temperate (25°C) environment, with an additional vigorous-intensity bout (70% of Vo2max) performed in a hot environment (40°C). Responses were evaluated before and after exercise, as well as throughout a 6-h seated recovery period performed in the same environmental conditions as the respective exercise bout. Proteins were assessed via Western blot. Although we observed elevations in mean body temperature with each increase in exercise intensity, autophagy was only stimulated during vigorous-intensity exercise, where we observed elevations in LC3-II (P < 0.05). However, when the same exercise was performed in the heat, the LC3-II response was attenuated, which was accompanied by significant p62 accumulation (P < 0.05). Altogether, our findings demonstrate that older adults exhibit autophagic impairments when the same vigorous-intensity exercise is performed in hot environments, potentially underlying heat-induced cellular vulnerability in older men. NEW & NOTEWORTHY We demonstrate that autophagic stimulation occurs in response to short-duration (30-min) vigorous-intensity exercise in peripheral blood mononuclear cells from older adults; however, no changes in autophagy occur during low- or moderate-intensity exercise. Moreover, older adults exhibit autophagic impairments when the same vigorous-intensity exercise is performed in hot ambient conditions. When paired with an attenuated heat shock response, as well as elevated apoptotic responses, older men may exhibit greater cellular vulnerability to exertional heat stress. [ABSTRACT FROM AUTHOR]

Pathogens develop resistance to various drugs while under the selective pressure of antibiotics resulting in the emergence of bacterial strains that are resistant to multiple treatment options. Unfortunately, the resistance to antibiotics has also been accompanied by a reduction in the development of novel antibiotics to combat various pathogens. Current diagnostic tools, which are used in parts of the early developmental process of antibiotics, primarily consist of static susceptibility tests that do not resemble the pharmacokinetics of the therapy in vivo. Here, we designed and 3D-printed cubical inserts with membranes on two of the cube faces that allow diffusion of a molecule across two planes. These inserts are used with a 3D-printed device to create a two-compartment model to mimic the pharmacokinetics of a molecule in humans from multiple types of administration. Fluorescein was used to characterize the device and the diffusion of molecules from a flowing channel, through a membrane in the first plane (representing the primary compartment in vivo, or plasma), followed by measurement in the second compartment (that represents the interstitial fluid). The dynamic, two-compartment model was tested using both gram-positive and gram-negative bacterial strains in the secondary compartment. The ATP/OD600 (a measure of antibiotic activity) of a kanamycin-resistant E. coli strain challenged with the antibiotic levofloxacin increased after reaching an effective concentration of the antibiotic at 2 h, equating to a secondary compartment concentration of 3.5 ± 1.3 µM levofloxacin. The ATP/OD600 of a chloramphenicol-resistant B. subtilis strain challenged with the antibiotic levofloxacin remained steady or increased slightly after reaching an effective concentration of the antibiotic. The earliest statistical difference was detected 3 h after the start of the PK curve, which corresponds with a secondary compartment concentration of 4.8 ± 1.8 µM levofloxacin. Our results demonstrate that a fabricated 2-compartment model (1) provides realistic PK values to those published from in vivo studies and (2) can be used to determine antibiotic pharmacodynamics. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, individuals depended on risk information to make decisions about everyday behaviors and public policy. Here, we assessed whether an interactive website influenced individuals' risk tolerance to support public health goals. We collected data from 11,169 unique users who engaged with the online COVID-19 Event Risk Tool (https://covid19risk.biosci.gatech.edu/) between 9/22/21 and 1/22/22. The website featured interactive elements, including a dynamic risk map, survey questions, and a risk quiz with accuracy feedback. After learning about the risk of COVID-19 exposure, participants reported being less willing to participate in events that could spread COVID-19, especially for high-risk large events. We also uncovered a bias in risk estimation: Participants tended to overestimate the risk of small events but underestimate the risk of large events. Importantly, even participants who voluntarily sought information about COVID risks tended to misestimate exposure risk, demonstrating the need for intervention. Participants from liberal-leaning counties were more likely to use the website tools and more responsive to feedback about risk misestimation, indicating that political partisanship influences how individuals seek and engage with COVID-19 information. Lastly, we explored temporal dynamics and found that user engagement and risk estimation fluctuated over the course of the Omicron variant outbreak. Overall, we report an effective large-scale method for communicating viral exposure risk; our findings are relevant to broader research on risk communication, epidemiological modeling, and risky decision-making. [ABSTRACT FROM AUTHOR]

Simple Summary: Adrenocortical carcinoma (ACC) is a rare, often deadly cancer arising from the adrenal gland. Mortality associated with ACC has remained unchanged over the last several decades. The rarity of ACC, an incomplete understanding of its molecular basis, and limited availability of pre-clinical models have hampered the development of novel therapeutic approaches. The present work aims to address these gaps with a focus on the Wnt/β-catenin cell signaling pathway, which is aberrantly activated in ~40% of ACC tumors. We discovered a novel ECM program activated in ACC that is associated with Wnt/β-catenin activation and poor survival. Wnt/β-catenin inhibition disrupted the expression of ECM genes and induced the loss of cancer cell viability. To extend these findings, we developed an orthotopic mouse model of rapidly progressive ACC and demonstrated that disruption of the Wnt/β-catenin axis with the novel small molecule inhibitor Tegavivint is a potential effective therapeutic strategy to reduce ACC tumor burden in vivo. Adrenocortical carcinoma (ACC) is a rare but highly aggressive cancer with limited treatment options and poor survival for patients with advanced disease. An improved understanding of the transcriptional programs engaged in ACC will help direct rational, targeted therapies. Whereas activating mutations in Wnt/β-catenin signaling are frequently observed, the β-catenin-dependent transcriptional targets that promote tumor progression are poorly understood. To address this question, we analyzed ACC transcriptome data and identified a novel Wnt/β-catenin-associated signature in ACC enriched for the extracellular matrix (ECM) and predictive of poor survival. This suggested an oncogenic role for Wnt/β-catenin in regulating the ACC microenvironment. We further investigated the minor fibrillar collagen, collagen XI alpha 1 (COL11A1), and found that COL11A1 expression originates specifically from cancer cells and is strongly correlated with both Wnt/β-catenin activation and poor patient survival. Inhibition of constitutively active Wnt/β-catenin signaling in the human ACC cell line, NCI-H295R, significantly reduced the expression of COL11A1 and other ECM components and decreased cancer cell viability. To investigate the preclinical potential of Wnt/β-catenin inhibition in the adrenal microenvironment, we developed a minimally invasive orthotopic xenograft model of ACC and demonstrated that treatment with the newly developed Wnt/β-catenin:TBL1 inhibitor Tegavivint significantly reduced tumor growth. Together, our data support that the inhibition of aberrantly active Wnt/β-catenin disrupts transcriptional reprogramming of the microenvironment and reduces ACC growth and survival. Furthermore, this β-catenin-dependent oncogenic program can be therapeutically targeted with a newly developed Wnt/β-catenin inhibitor. These results show promise for the further clinical development of Wnt/β-catenin inhibitors in ACC and unveil a novel Wnt/β-catenin-regulated transcriptome. [ABSTRACT FROM AUTHOR]

The article reports that Bivalent COVID-19 booster vaccines, developed to protection against Omicron BA.4/BA.5 variants of SARS-CoV-2 infection. Topics include help increase bivalent booster dose coverage, health care and public health professionals should use evidence-based strategies to convey information about booster vaccination recommendations; and previous COVID-19 infections as determined by positive rapid test results or reverse transcription-polymerase chain reaction test results.

A new, four-chord, CO2/He–Ne heterodyne interferometer has been designed and built for measuring line-averaged plasma density in the HIT-SI3 and subsequent HIT-SIU sustained spheromak devices. The two-color system successfully eliminates vibration-induced errors caused by mirrors that are secured to the vacuum chamber and is able to resolve electron densities ne in the full operating range of 1018–1020 m−3 in both experiments with an integrated error of 4.7 × 1017 m−2. Data are presented from high toroidal current plasma discharges, showing the time evolution of electron densities ne and jϕ/ne along multiple chords. [ABSTRACT FROM AUTHOR]

Our beliefs about aging affect how we interact with others. For example, people know that episodic memory declines with age, and as a result, older adults' memories are less likely to be trusted. However, not all aspects of remembering decline with age; semantic memory (knowledge) increases across adulthood and is relatively unaffected in healthy aging. In the current work, we examined people's awareness of this pattern. Participants estimated the knowledge of hypothetical younger and older adults; in some studies, they also predicted and demonstrated their own knowledge on the same measures. Across studies, both younger and older adults estimated that older adults would perform better on a knowledge test, demonstrating awareness that knowledge is not impaired with aging. Furthermore, people's beliefs about their own knowledge influenced the predictions they made about others' knowledge. We discuss how this work informs theories of metacognition and contributes to positive self-perceptions in older adulthood. [ABSTRACT FROM AUTHOR]

The HIT-SI3 device at the University of Washington uses three oscillating inductive helicity injectors to form and sustain spheromak plasma equilibria. By adjusting the temporal phase of the injector waveforms with respect to each other, the toroidal spectrum of the imposed perturbations can be controlled. Using a recently implemented GPU-based control system, the available mode spectra were explored experimentally by scanning the space of relative injector phasing. In this space, significant variation in the toroidal mode spectrum (n = 1, 2, 3) of the perturbations was observed. Additionally, variation in characteristics of driven equilibria was also observed, including a ≈ 30 % range in toroidal current gain ( I ϕ / I Inj ). Experimental results are compared with both a composite-equilibria and nonlinear dynamic model, including extended MHD simulations using the NIMROD code and composite Taylor state equilibria computed using the PSI-Tet code. Qualitative agreement is seen with the nonlinear models, but not with composite-equilibria models, suggesting the use of nonlinear models to better capture observed plasma dynamics and provide predictive use for future experiments. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to test the validity of the Organizational Learning in Hospitals model in the context of the COVID‐19 pandemic. Background: Organizational learning is especially crucial in circumstances of intense, complex, enduring change, as with the COVID‐19 pandemic. Nurse managers need additional guidance for fostering organizational learning under such circumstances. The Organizational Learning in Hospitals model may be a helpful resource but requires additional validation. Methods: Semi‐structured interviews were conducted to gather 19 nurses' first‐hand experiences of organizational learning during the COVID‐19 pandemic. Data were analysed using deductive thematic analysis. Results: Nurses' experiences of organizational learning generally aligned with the tenets of the model. Specifically, effective organizational learning occurred when the contextual factors and mechanisms portrayed in the model converged. Model and contrary cases illustrate this phenomenon. Conclusions: This study validates and adds context to the model. It offers practical examples of the contextual factors and mechanisms of organizational learning. Leaders can use the model to guide their efforts to foster organizational learning. Implications for Nursing Management: This study reaffirms the importance of nurse leaders' central role in organizational learning. Nurse leaders can use the Organizational Learning in Hospitals model, and the practical examples provided, to foster organizational learning during challenging times. [ABSTRACT FROM AUTHOR]

Background: Both national and international guidelines recommend that parturients fast from solids and clear fluids for six and two hours, respectively, prior to a caesarean section (c-section) in order to reduce the risk of pulmonary aspiration. The objective of this study was to evaluate whether fasting times conform to the current American Society of Anesthesiologists' (ASA) recommendations and whether prolonged fasting times are associated with metabolic sequelae, namely hypoglycaemia and ketonuria. Methods: A total of 56 parturients were enrolled and interviewed at Tygerberg Hospital, a tertiary referral hospital in Cape Town, South Africa. Women who were unable to provide consent (below the age of 18) and/or women who were not scheduled for an elective c-section were excluded from the study. Whole blood glucose and urine ketone levels were measured immediately before anaesthesia. Results: Fasting times for solids and fluids were 15 hours (IQR 12-18; 95% CI 14-17) and 14 hours (IQR 11-16; 95% CI 12-15), respectively. During the preceding week, 32% of the participants were subjected to repeated fasting periods with a median cumulative time (all the fasting periods added) of 40 hours (IQR 35-64; range 28-133). Hypoglycaemia occurred in 39.3% (95% CI 26.8-53.3) and significant ketonuria occurred in 51.8% (95% CI 38.1-65.1) of the participants, with both conditions associated with longer fasting times (p < 0.001). A sigmoid relationship was observed between fasting time and the probability of hypoglycaemia. Hypoglycaemia was unlikely to occur before nine hours of fasting, and thereafter, the risk of hypoglycaemia increased 1.5-fold per hour (95% CI 1.2-1.8). Conclusion: Fasting times before an elective c-section were longer than what is recommended by the ASA guidelines and were associated with statistically and clinically significant metabolic consequences. Maternal glucose should be checked after nine hours of fasting, since the incidence of hypoglycaemia exceeds 5% after nine hours of fasting. Adherence to outdated fasting practices should also be addressed. Fasting time may be a simple, useful healthcare quality indicator. [ABSTRACT FROM AUTHOR]

A real-time control system has been developed to control the amplitude, phase, and offset of bulk plasma parameters inside an oscillating magnetic helicity injector. Control software running entirely on an Nvidia Tesla P40 graphical processing unit is able to receive digitizer inputs and send response patterns to a Pulse Width Modulation (PWM) controller with a minimum control loop period of 12.8 µs. With an input digitization rate of 10 MS/s, a three-parameter proportional integral differential controller is shown to be sufficient to inform the PWM controller to drive the desired oscillating plasma waveform with a frequency of 16.6 kHz that is located near the resonance of a coupled RLC circuit. In particular, the temporal phase of the injector waveform is held within 10° of the target value. Control is demonstrated over the toroidal modal structure of the imposed magnetic perturbations of the helicity injection system, allowing a new class of discharges to be studied. [ABSTRACT FROM AUTHOR]

An extremely rare example of well‐preserved emergent Holocene fossil reefs exists at Kiritimati Island, central Pacific. Fossil reefs are rich geological archives of paleoenvironmental change. The first paleoecological surveys of two fossil reefs are presented, revealing high coral cover (40–50%) and low diversity (6 genera). Fossil coral ages suggest reefs exhibited disparity in the timing of reef development (4,113 and 1,915 cal yBP) and ecological surveys show different coral compositions (Acropora or Porites dominant), between reefs. Results constrain two discrete episodes of reef shutdown (at 2,905 and 1,705 cal yBP) as lagoonal reefs thrived, and subsequently died off, through the late Holocene. Shifts in physio‐chemical conditions associated with reduced lagoon flushing following storm‐driven changes in atoll rim morphology are argued as the driver for the staged reef die‐off. The findings have implications for interpreting past and future eco‐morphological change on atolls, given projected increases in storminess with climate change. Plain Language Summary: Fossil coral reefs include the skeletal remains of corals and are rarely preserved in good condition above modern sea level. Such reefs are rich archives that hold information about past environmental and ecological conditions at the time of reef development. A rare and expansive example of fossil reefs grew during the period 7,000 to 1,000 years ago at Kiritimati Island, Kiribati. Surveys and radiometric dating were used to reveal, for the first time, the age, elevation, and coral ecology of two of the most well‐preserved fossil reefs on Kiritimati Island (between 4,000 and 2,000 years ago). Results show that the reefs flourished during different time periods and were dominated by different coral taxa, before dying off. We argue that reef die‐off is attributed to changing lagoon seawater conditions that became intolerable for coral growth. These changing water conditions were the result of storm‐induced changes at the atoll rim that enclosed the lagoon and reduced flushing. As tropical cyclones are projected to increase in frequency and severity under global climate change, our results are critical for understanding the future responses of mid‐oceanic atolls and their supporting ecologies. Key Points: Reef condition at two emergent fossil reticulate reefs in Kiribati was reconstructed using paleoecological surveys and radiometric datingTemporally distinct episodes of reef growth, followed by reef shutdown, were observed through the late HoloceneReef shutdown was likely associated with storm‐deposited ridges on the atoll rim, driving changes in lagoon water, restricting coral growth [ABSTRACT FROM AUTHOR]

• We tested a new method for mapping honey bee waggle dances using two data sets. • This method was faster than previous calibration and avoided some mapping artefacts. • Its accuracy was similar to previous calibration but it was affected by distance. • The new method outperformed the old method for resources at closer distances. [ABSTRACT FROM AUTHOR]

Background: Candida spp. infective endocarditis (CIE) although rare is associated with high morbidity and mortality. Risk factors include prosthetic heart valves and injection drug use (IDU). We reviewed all cases of CIE at our institution to describe the microbiology, treatment and outcomes of patients focusing on IDU as a predisposing factor. Methods: Retrospective cohort of patients with definite CIE between 2013 and 2019 at a university hospital was analysed. Demographic data collected included IDU, microbiologic, treatment and mortality. The primary outcome of interest was 12‐month, all‐cause mortality. Results: Twenty patients were included (one had two separate episodes of CIE); CIE accounted for 4% of total infective endocarditis (IE) cases during the study period. The median (IQR) age was 38 (30‐58) years, 10 (50%) had a previous history of IE, and 4 (20%) patients had prosthetic heart valves or an implanted cardiac device. Thirteen (65%) patients were IDU. The tricuspid valve was the primary valve involved (8/18, 44%), and C albicans was the most frequently isolated organism (8, 36%). Echinocandin was the most common treatment strategy (8, 40%). Only three (15%) patients underwent valve replacement during hospitalisation. There were no in‐hospital fatalities, and 5 (25%) patients died at one year; all were IDU (39% to 0%, p =.11). Conclusion: CIE is a rare infectious disease seen more commonly in the IDU population. Cardiac surgery was rarely performed, and long‐term mortality was 25%. Additional data are needed to identify ideal management strategies in this population. [ABSTRACT FROM AUTHOR]

Introduction: pH impedance testing is the most sensitive diagnostic test for detecting gastroesophageal reflux disease (GERD). The literature remains inconclusive on which preoperative pH impedance testing parameters are associated with an improvement in heartburn symptoms after anti-reflux surgery. The objective of this study was to evaluate which parameters on preoperative pH impedance testing were associated with improved GERD health-related quality of life (GERD-HRQL) following surgery.Methods: Data from a single-institution foregut database were used to identify patients with reflux symptoms who underwent anti-reflux surgery between 2014 and 2020. Acid and impedance parameters were extracted from preoperative pH impedance studies. GERD-HRQL was assessed pre- and postoperatively with a questionnaire that evaluated heartburn, dysphagia, and the impact of acid-blocking medications on daily life. Patient characteristics, fundoplication type, and four pH impedance parameters were included in a multivariable linear regression model with improvement in GERD-HRQL as the outcome.Results: We included 108 patients (59 Nissen and 49 Toupet fundoplications), with a median follow-up time of 1 year. GERD-HRQL scores improved from 22.4 (SD ± 10.1) preoperatively to 4.2 (± 6.2) postoperatively. In multivariable analysis, a normal preoperative acid exposure time (p = 0.01) and Toupet fundoplication (vs. Nissen; p = 0.03) were independently associated with greater improvement in GERD-HRQL.Conclusions: Of the four pH impedance parameters that were investigated, a normal preoperative acid exposure time was associated with greater improvement in quality of life after anti-reflux surgery. Further investigation into the critical parameters on preoperative pH impedance testing using a multi-institutional cohort is warranted. [ABSTRACT FROM AUTHOR]

PREMISE: Plant genome size ranges widely, providing many opportunities to examine how genome size variation affects plant form and function. We analyzed trends in chromosome number, genome size, and leaf traits for the woody angiosperm clade Viburnum to examine the evolutionary associations, functional implications, and possible drivers of genome size. METHODS: Chromosome counts and genome size estimates were mapped onto a Viburnum phylogeny to infer the location and frequency of polyploidization events and trends in genome size evolution. Genome size was analyzed with leaf anatomical and physiological data to evaluate the influence of genome size on plant function. RESULTS: We discovered nine independent polyploidization events, two reductions in base chromosome number, and substantial variation in genome size with a slight trend toward genome size reduction in polyploids. We did not find strong relationships between genome size and the functional and morphological traits that have been highlighted at broader phylogenetic scales. CONCLUSIONS: Polyploidization events were sometimes associated with rapid radiations, demonstrating that polyploid lineages can be highly successful. Relationships between genome size and plant physiological function observed at broad phylogenetic scales may be largely irrelevant to the evolutionary dynamics of genome size at smaller scales. The view that plants readily tolerate changes in ploidy and genome size, and often do so, appears to apply to Viburnum. [ABSTRACT FROM AUTHOR]

Background Sepsis is an important cause of morbidity and mortality in the pregnant patient. Injection drug use in pregnant populations has led to increased cases of bacteremia and infective endocarditis (IE) due to Staphylococcus aureus. We describe all cases of S. aureus bacteremia and IE among admitted pregnant patients at our hospital over a 6-year period. Methods This was a retrospective review of pregnant patients hospitalized with S. aureus bacteremia between April 2013 and November 2019. Maternal in-hospital mortality and fetal in-hospital mortality were the primary outcomes measured; the secondary outcome was the rate of 6-month maternal readmission. Results Twenty-seven patients were included; 15 (56%) had IE. The median (interquartile range [IQR]) age was 29 (25–33) years; 22 (82%) patients had methicillin-resistant S. aureus. Infection onset occurred at a median (IQR) of 29 (23–34) weeks' gestation. Twenty-three (85%) mothers reported active injection drug use, and 21 (78%) were hepatitis C seropositive. Fifteen (56%) mothers required intensive care unit (ICU) care. Twenty-two (81%) patients delivered 23 babies; of the remaining 5 mothers, 3 (11%) were lost to follow-up and 2 (7%) terminated pregnancy. Sixteen (73%) babies required neonatal ICU care, and 4/25 (16%) infants/fetuses died during hospitalization. One (4%) mother died during hospitalization, and 7/26 (27%) mothers were readmitted to the hospital within 6 months for infectious complications. Conclusions Injection drug use is a modifiable risk factor for S. aureus bacteremia in pregnancy. Fetal outcomes were poor, and mothers were frequently readmitted secondary to infection. Future targeted interventions are needed to curtail injection drug use in this population. [ABSTRACT FROM AUTHOR]

Individuals with fibromyalgia are at greater risk for depressive symptoms than the general population, and this may be partially attributable to physical symptoms that impair day‐to‐day functioning. However, individual‐level protective characteristics may buffer risk for psychopathology. For instance, the ability to perceive a "silver lining" in one's illness may be related to better mental and physical health. We examined perceived silver lining as a potential moderator of the relation between fibromyalgia impact and depressive symptoms. Our sample of persons with fibromyalgia (N = 401) completed self‐report measures including the Fibromyalgia Impact Questionnaire‐Revised, Depression Anxiety Stress Scales, and the Silver Lining Questionnaire. Moderation analyses covaried age, sex, and ethnicity. Supporting hypotheses, increasing impact of disease was related to greater depressive symptoms, and perceptions of a silver lining attenuated that association. Despite the linkage between impairment and depressive symptoms, identifying positive aspects or outcomes of illness may reduce risk for psychopathology. Therapeutically promoting perception of a silver lining, perhaps via signature strengths exercises or a blessings journal, and encouraging cognitive reframing of the illness experience, perhaps via Motivational Interviewing or Cognitive Behavioral Therapy, may reduce depressive symptoms in persons with fibromyalgia. [ABSTRACT FROM AUTHOR]

Biocultural anthropology has long represented an important approach in the study of human biology. However, despite demonstrated utility, its somewhat amorphous identity leaves some scholars questioning just what it means to be biocultural. In this article, rather than providing proscriptive doctrine, we contribute to these conversations about the nature of biocultural anthropology by considering what biocultural research does. We begin with a consideration of some of the foundational themes of biocultural work including recognition of the dialectical nature of sociocultural and biological forces, interest in inequality, and incorporation of both evolutionary and political economic perspectives. To emphasize the consistency of biocultural work over time, we also trace these themes from originating work to their appearance in current research. We then identify some of the key actions of the biocultural approach, noting that biocultural work can execute any number though rarely all of these actions simultaneously. We then offer brief introductions to the articles that make up this special issue, highlighting the ways in which each piece undertakes key biocultural actions. Following these introductions, we provide a discussion of some of the types of biocultural work that are not present in this special issue, recognizing the breadth of biocultural research across multiple subfields of anthropology. Finally, we point to some potentially fruitful directions for future biocultural research. In the end, we conclude that while biocultural anthropology may not have a cohesive or set agenda, it does have a clear and recognizable form of content and methodology illuminated by its actions. [ABSTRACT FROM AUTHOR]

Objectives: Chronic malnutrition remains a persistent global health issue. This mixed methods investigation in rural Peru examines the role of home food production (HFP) in reducing child malnutrition by testing the following hypotheses: (a) higher HFP will be associated with higher infant z‐scores than those with less HFP and (b) infants with higher HFP will exhibit improved longitudinal growth outcomes across 6 months. Methods: Ethnographic methods include semi‐structured interviews and participant observation. A household survey and anthropometric data were collected twice, from 86 infants under of 24 months old. A HFP index (HFI) was generated based on reports of animals for meat consumption, eggs, milk, and agricultural products for home consumption. Kruskal‐Wallis tests were used to examine patterns of HFI and infant anthropometrics. Multivariate regressions were used to examine the relationships between HFP and infant height for age (HAZ), weight for age (WAZ), and triceps skinfold for age (TSAZ) in both rounds and 6‐month change between rounds (6MΔ). Results: There were no relationships between HFI and infant z‐scores in round one, however, HFI was significantly positively related to HAZ (B = 0.091, P <.039) in round two and with 6MΔ in HAZ (B = 0.09, P <.047). HFI did not predict WAZ or TSAZ in either round. Conclusions: HFP represents an important influence of infant growth in Nuñoa, likely through nutritional improvement due to increased availability of animal‐sourced foods and through contribution to household economy and maternal empowerment. [ABSTRACT FROM AUTHOR]

Although the trajectories of children's social skills have been examined across biological sexes, less research has examined these patterns for racially and ethnically diverse children in the United States. The purpose of this study was to estimate the longitudinal growth trajectories of social skills, while examining the influence of biological sex, race, and ethnic identities using an adaptation of the commonly used Social Skills Rating Scale. A large nationally representative sample of elementary school children in the United States were assessed annually from kindergarten through fifth grade (N = 11,792). Structural equation modeling was used to examine latent growth curve models of teacher‐rated interpersonal skills and self‐control. After finding evidence of longitudinal invariance, results suggested a quadratic growth pattern best represented the trajectories of social skills ratings. Teacher ratings for African American children demonstrated a moderate declining linear trajectory throughout elementary school when compared with White children (reference group) and their Asian and Hispanic peers. Children from families with higher socioeconomic status and girls showed moderate to large differences in social skills ratings in kindergarten and stronger growth across time. Implications of the findings with future directions for research are discussed. Practitioner Points: Teacher ratings of children's social skills differ by child demographics.Teacher ratings for African American children show a decline throughout elementary school compared to peers.Children from families with higher socioeconomic status and girls showed larger differences and stronger growth. [ABSTRACT FROM AUTHOR]

Microwave SQUID multiplexing has become a key technology for reading out large arrays of X-ray and gamma-ray microcalorimeters with mux factors of 100 or more. The desire for fast X-ray pulses that accommodate photon counting rates of hundreds or thousands of counts per second per sensor drives system design toward high sensor current slew rate. Typically, readout of high current slew rate events is accomplished by increasing the sampling rate, such that rates of order 1 MHz may be necessary for some experiments. In our microwave multiplexed readout scheme, the effective sampling rate is set by the frequency of the flux-ramp modulation ( f r ) used to linearize the SQUID response. The maximum current slew rate between samples is then nominally Φ 0 f r / 2 M in (where M in is the input coupling) because it is generally not possible to distinguish phase shifts of > π from negative phase shifts of < - π . However, during a pulse, we know which direction the current ought to be slewing, and this makes it possible to reconstruct a pulse where the magnitude of the phase shift between samples is > π . We describe a practical algorithm to identify and reconstruct pulses that exceed this nominal slew rate limit on the rising edge. Using pulses produced by X-ray transition-edge sensors, we find that the pulse reconstruction has a negligible impact on energy resolution compared to arrival time effects induced by under-sampling the rising edge. This technique can increase the effective slew rate limit by more than a factor of two, thereby either reducing the resonator bandwidth required or extending the energy range of measurable photons. The extra margin could also be used to improve crosstalk or to decrease readout noise. [ABSTRACT FROM AUTHOR]

Background: Heller myotomy (HM) has historically been considered the gold standard treatment for achalasia. Peroral endoscopic myotomy (POEM) is a less-invasive procedure and offers a quicker recovery. Although some studies have compared short-term outcomes of HM and POEM, predictors of long-term dysphagia resolution remain unclear. The objective of this study was to evaluate patient-reported outcomes for achalasia patients who underwent either POEM or HM over a 9-year period.Methods: Data from our single academic institutional foregut database were used to identify achalasia patients who underwent HM or POEM from 2009 to 2018. Electronic health record data were reviewed to obtain patient characteristics and operative data. Achalasia severity stages were established for each patient using esophagram findings from an attending radiologist blinded to the procedure type. Postoperative outcomes were assessed via telephone for patients with at least 9 months of follow-up using Eckardt dysphagia scores. Patient age, sex, type of operation, and duration of follow-up were included in a multivariable linear regression model with Eckardt score as the outcome.Results: Our cohort included 141 patients (97 HM and 44 POEM). Eighty-two patients completed a phone survey at the 9 months or greater time interval (response rate = 58%). Mean Eckardt scores were 2.98 and 2.53 at a median follow-up of 3 years and 1 year for HM and POEM patients, respectively (an Eckardt score ≤ 3 is considered a successful myotomy). Lower stages of achalasia on esophagram (e.g., Stage 0 vs. Stage 4) were associated with greater dysphagia improvement. On multivariable analysis, operative approach was not associated with a statistically significant difference in dysphagia outcomes.Conclusions: POEM and HM were associated with similar rates of dysphagia resolution for achalasia patients at a median of 2 years of follow-up. Both procedures appear to be durable options for achalasia treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Families of children with autism spectrum disorder (ASD) often experience challenges navigating multiple systems to access services. Family navigation (FN) is a model to provide information and support to access appropriate services. Few studies have been used to examine FN's effectiveness for families of children with ASD. This study used mixed methods to (1) characterize FN services received by a sample of families in the Autism Treatment Network; (2) examine change in parent-reported activation, family functioning, and caregiver strain; and (3) explore families' experiences with FN services. METHODS: Family characteristics and parent outcomes including parent activation, family functioning, and caregiver strain were collected from 260 parents in the Autism Treatment Network. Descriptive statistics and linear mixed models were used for aims 1 and 2. A subsample of 27 families were interviewed about their experiences with FN services to address aim 3. RESULTS: Quantitative results for aims 1 and 2 revealed variability in FN services and improvement in parent activation and caregiver strain. Qualitative results revealed variability in family experiences on the basis of FN implementation differences (ie, how families were introduced to FN, service type, intensity, and timing) and whether they perceived improved skills and access to resources. CONCLUSIONS: Findings suggest FN adaptations occur across different health care delivery systems and may result in highly variable initial outcomes and family experiences. Timing of FN services and case management receipt may contribute to this variability for families of children with ASD. [ABSTRACT FROM AUTHOR]

Accurate and efficient plasma models are essential to understand and control experimental devices. Existing magnetohydrodynamic or kinetic models are nonlinear and computationally intensive and can be difficult to interpret, while often only approximating the true dynamics. In this work, data-driven techniques recently developed in the field of fluid dynamics are leveraged to develop interpretable reduced-order models of plasmas that strike a balance between accuracy and efficiency. In particular, dynamic mode decomposition (DMD) is used to extract spatio-temporal magnetic coherent structures from the experimental and simulation datasets of the helicity injected torus with steady inductive (HIT-SI) experiment. Three-dimensional magnetic surface probes from the HIT-SI experiment are analyzed, along with companion simulations with synthetic internal magnetic probes. A number of leading variants of the DMD algorithm are compared, including the sparsity-promoting and optimized DMD. Optimized DMD results in the highest overall prediction accuracy, while sparsity-promoting DMD yields physically interpretable models that avoid overfitting. These DMD algorithms uncover several coherent magnetic modes that provide new physical insights into the inner plasma structure. These modes were subsequently used to discover a previously unobserved three-dimensional structure in the simulation, rotating at the second injector harmonic. Finally, using data from probes at experimentally accessible locations, DMD identifies a resistive kink mode, a ubiquitous instability seen in magnetized plasmas. [ABSTRACT FROM AUTHOR]

Honey bee (Apis mellifera) colonies are valued for the pollination services that they provide. However, colony mortality has increased to unsustainable levels in some countries, including the United States. Landscape conversion to monocrop agriculture likely plays a role in this increased mortality by decreasing the food sources available to honey bees. Many land owners and organizations in the Upper Midwest region of the United States would like to restore/reconstruct native prairie habitats. With increasing public awareness of high bee mortality, many landowners and beekeepers have wondered whether these restored prairies could significantly improve honey bee colony nutrition. Conveniently, honey bees have a unique communication signal called a waggle dance, which indicates the locations of the flower patches that foragers perceive as highly profitable food sources. We used these communication signals to answer two main questions: First, is there any part of the season in which the foraging force of a honey bee colony will devote a large proportion of its recruitment efforts (waggle dances) to flower patches within prairies? Second, will honey bee foragers advertise specific taxa of native prairie flowers as profitable pollen sources? We decoded 1528 waggle dances in colonies located near two large, reconstructed prairies. We also collected pollen loads from a subset of waggle-dancing bees, which we then analyzed to determine the flower taxon advertised. Most dances advertised flower patches outside of reconstructed prairies, but the proportion of dances advertising nectar sources within prairies increased significantly in the late summer/fall at one site. Honey bees advertised seven native prairie taxa as profitable pollen sources, although the three most commonly advertised pollen taxa were non-native. Our results suggest that including certain native prairie flower taxa in reconstructed prairies may increase the chances that colonies will use those prairies as major food sources during the period of greatest colony growth and honey production. [ABSTRACT FROM AUTHOR]

The objective of this translational study was to evaluate the FDA‐approved PediMag, CentriMag, and RotaFlow centrifugal blood pumps in terms of hemodynamic performance using simulated neonatal and pediatric extracorporeal membrane oxygenation (ECMO) circuits with different sizes of arterial and venous cannulae. Cost of disposable pump heads was another important variable for this particular study. The experimental circuit was composed of one of the centrifugal pump heads, a polymethylpentene membrane oxygenator, neonatal and pediatric arterial/venous cannulae, and 1/4‐inch ID tubing. Circuits were primed with lactated Ringer's solution and packed human red blood cells (hematocrit 35%). Trials were conducted at 36°C using the three pump heads and different cannulae (arterial/venous cannulae: 8 Fr/18 Fr, 10 Fr/20 Fr, and 12 Fr/22 Fr) at various flow rates (200–2400 mL/min, 200 mL/min increments) and rotational speeds. Pseudo patient pressure was 60 mm Hg. Real‐time pressure and flow data were recorded for analysis. The RotaFlow pump had a higher pressure head and flow range compared with the PediMag and CentriMag pumps at the same rotational speed and identical experimental settings (P < 0.001). The PediMag pump had lower flow output than others (P < 0.001). Small‐caliber arterial cannulae and higher flow rates predictably created higher circuit pressures and pressure drops. There was no significant difference in hemodynamic energy delivered to the pseudo patient with each of the three pumps. The arterial cannula had the highest pressure drop and hemodynamic energy loss in the circuit when compared to the oxygenator and arterial tubing. The RotaFlow centrifugal pump had a significantly better hemodynamic performance when compared to the PediMag and CentriMag blood pumps at identical experimental conditions in simulated neonatal and pediatric ECMO settings. In addition, the cost of the RotaFlow pump head ($400) is 20 to 30‐fold less than the other centrifugal pumps [CentriMag ($12 000) or PediMag ($8000)] that were evaluated in this translational study. [ABSTRACT FROM AUTHOR]

Deep-seated educational discourses have blamed low-income communities for their youth's lack of high school completion. These deficit discourses reflect top-down knowledge hierarchies and a lack of knowledge democracy in education (de Sousa Santos 2007; Hall & Tandon 2017; Visvanathan 2009), and they are in need of 'critical and diverse knowledge reckoning' (Malone 2019, p. 2) by low-income communities themselves. This article relays how a community-university participatory action research (PAR) partnership became a dynamic site of knowledge democracy from which to counter and transform deficit-based knowledge systems imposed on economically disadvantaged communities. Steeped in the generative enactments of PAR, storytelling, ecological metaphor, strength-based approaches and the arts, this article explores a low-income/social housing community's knowledge practices that are energising and growing its community power to support the success of their youth in school. These seven knowledge practices are narrated through the ecological metaphor of trees, specifically via a co-constructed PAR team narrative called the Tree of Community Knowledge and Engagement. In the telling and retelling of this counternarrative-in-the-making, this article embodies knowledge democracy. Here, community members' energising knowledge practices are recognised as invaluable forms of everyday educational knowing and leadership for their youth. This article further explores three broad ways of knowing that reside within and across community members' seven knowledge practices: lived knowing, interconnected knowing and participatory/power-in-relation knowing. The three community ways of knowing illustrate how the community is growing its power to support youth's success via a transformative educational worldview, from which other schools and universities could learn and, indeed, thrive. [ABSTRACT FROM AUTHOR]

Introduction: Military personnel and civilian athletes are both at risk for mild traumatic brain injury. However, these groups are unique in their training and typical daily activities. A fundamental gap in the evaluation of military personnel following mild traumatic brain injury is the lack of military-specific normative reference data. This project aimed to determine if a separate normative sample should be used for military personnel on their performance of the Cleveland Clinic Concussion application and a recently developed dual-task module.Methods: Data were collected from healthy military personnel (n = 305) and civilians (n = 281) 18 to 30 years of age. Participants completed the following assessments: simple and choice reaction time, Trail Making tests A&B, processing speed test, single-task postural stability, single-task cognitive assessment, and dual-task assessment.Results: Civilian participants outperformed military service members on all cognitive tasks under single- and dual-task conditions (P ≤ 0.04). The military group outperformed civilians on all postural stability tasks under single- and dual-task conditions (P ≤ 0.01).Conclusion: Differences in cognitive performance and postural stability measures may be influenced by demographic differences between military and civilian cohorts. Thus, military-specific normative datasets must be established to optimize clinical interpretation of Cleveland Clinic Concussion assessments. [ABSTRACT FROM AUTHOR]

Post-copulatory sexual selection, through either sperm competition or cryptic female choice, is an important aspect of sexual selection in hermaphrodites. We investigated sperm precedence, non-random fertilization of eggs by multiple partners, to determine the potential for sperm competition in the hermaphroditic freshwater snail Planorbella trivolvis. We provided snails with two sequential partners, and assessed paternity using albinism as a genetic marker. We mated albino snails first to a pigmented partner then an albino (PA; n = 26) or first to an albino then a pigmented individual (AP; n = 27) and calculated the proportion of eggs fertilized by the second partner (P2) during the 1st, 3rd, and 5th week post-mating. We collected all egg masses laid each week (~300) and examined the embryos to determine paternity by the presence or absence of eye pigmentation. P2 values were quite low (0.18 ± 0.04) indicating strong first sperm precedence and thus little opportunity for sperm competition. We also found that mating order influenced precedence; when the first mate was an albino P2 values were higher than when the first mate was pigmented, suggesting a difference in sperm transfer or viability or a preference for pigmented partners. [ABSTRACT FROM AUTHOR]

This study was designed to evaluate cardiac and respiratory dysfunction in a mouse model of sudden unexpected death in epilepsy i.e., SUDEP. We simultaneously monitored respiration via plethysmography and the electrocardiogram via telemetry before, during, and after an audiogenic seizure. DBA/1 mice responded to an acoustic stimulus with one or two cycles of circling and jumping before entering a clonic/tonic seizure. This was followed by death unless the mice were resuscitated by mechanical ventilation using room air. During the initial clonic phase, respiration declined and cardiac rhythm is slowed. By the tonic phase, respiration had ceased, atrial P-waves were absent or dissociated from the QRS complex, and heart rate had decreased from 771±11 to 252±16 bpm. Heart rate further deteriorated terminating in asystole unless the mice were resuscitated at the end of the tonic phase which resulted in abrupt recovery of P-waves and a return to normal sinus rhythm, associated with gasping. Interestingly, P-waves were preserved in the mice treated with methylatropine during the pre-ictal period (to block parasympathetic stimulation) and heart rate remained unchanged through the end of the tonic phase (765±8 vs. 748±21 bpm), but as in control, methylatropine treated mice died from respiratory arrest. These results demonstrate that a clonic/tonic seizure in the DBA/1 mouse results in abrupt and simultaneous respiratory and cardiac depression. Although death clearly results from respiratory arrest, our results suggest that seizure activates two central nervous system pathways in this model—one inhibits respiratory drive, whereas the other inhibits cardiac function via vagal efferents. The abrupt and simultaneous recovery of both respiration and cardiac function with mechanical ventilation within an early post-ictal timeframe shows that the vagal discharge can be rapidly terminated. Understanding the central mechanism associated with the abrupt cardiorespiratory dysfunction and equally abrupt recovery may provide clues for therapeutic targets for SUDEP. [ABSTRACT FROM AUTHOR]

The debate over the importance of pulsatile flow has been discussed since Hippocrates and Aristotle; however, in 1955, Wesolowski performed the initial laboratory studies in pulsatile versus nonpulsatile perfusion during cardiopulmonary bypass (CPB) procedures.[1] Although early CPB pulsatile pumps introduced greater complexity and only marginal benefits in the 1950s and 1960s, a few pulsatile roller pumps showed advanced commercial production and clinical use in the late 1970s and early 1980s after demonstrating lower mortality rates and a decreased need for postoperative intra-aortic balloon pulsation.[[2]] Despite this, the controversy over the benefits of pulsatile flow during acute and long-term extracorporeal circulation still continues.[4] Our pediatric cardiovascular research team at Penn State Children's Hospital and Penn State College of Medicine has a long-standing dedication to this controversial debate and uses a multidisciplinary translational research approach to further examine this issue.[[5]] The objective of this editorial is to clarify common myths related to the effects of pulsatile flow on circuit optimization and vital organ recovery in congenital heart surgery patients undergoing CPB using data generated at the Penn State Pediatric Cardiovascular Research Center. Myth: Pulsatile flow eliminates the adverse effects of CPB procedures on vital organ injury and reduces the length of ICU as well as hospital stay for congenital heart surgery patients. The entire CPB circuit, not just the pump, should be optimized in order to safely utilize pulsatile flow for congenital heart surgery patients. [Extracted from the article]

Background: Meta-analyses of randomized controlled trials comparing atrial fibrillation (AF) ablation to medical therapy in patients with heart failure (HF) reported improvement in left ventricular ejection fraction (LVEF), quality of life using the Minnesota Living with HF Questionnaire (MLWHFQ), and 6-minute walk test (6MWT). Nonetheless, there was significant heterogeneity not accounted for suggesting that not all HF patients derive the same effect from AF ablation. Objectives: To evaluate if baseline LVEF or the etiology of the cardiomyopathy would moderate the efficacy of AF ablation. Methods: We performed random effects meta-regression using the mean baseline LVEF and total percentage of patients with nonischemic cardiomyopathy (NICMP) in the placebo arms as moderator variables. Results: Six trials with a total of 687 patients were included. The baseline LVEF in the control arm of trials ranged from 25% - 42.9%, and the percentage of patients with NICMP within each trial varied from 35% to 100%. When baseline LVEF was used as the moderator variable, no significant change in heterogeneity was observed for any of the outcomes of interest (R2 0.00 - 0.02). However, when controlling for NICMP, heterogeneity dropped substantially for the outcomes of LVEF (I2 44.7%, R2 0.91), and MLWHFQ (I2 0.00%, R2 1.00) but not 6MWT (I2 67.4%, R2 0.00). This indicates that improvement in LVEF and MLWHFQ was greater in the AF ablation group when more patients with NICMP were included in the trials. Conclusions: In patients with systolic HF, AF ablation may be more beneficial in patients with NICMP. [ABSTRACT FROM AUTHOR]

• Patients with IBD have increased risk of venous thromboembolism. • At LSUHSC-S, VTE was 3x more associated with CD than UC. • VTE events were more common in white females. • African American males had fewer years since IBD diagnosis than white counterparts. Although coagulation disturbances have been described in inflammatory bowel disease (IBD), it remains unclear how common venous thromboembolism (VTE) is in IBD, and what factors influence VTE frequency. We evaluated VTE in Crohn's disease (CD) and ulcerative colitis (UC) at LSUHSC-S, a southern US medical center with an approximately equal White: African-American (AA) (1.12:1) patient base. This retrospective study evaluated VTE as a co-morbidity in IBD as a function of age, gender and race based on ICD-10 coding (2011−2015.) Results. Of 276 IBD diagnostic records, 213 were for CD (77.17%) and 63 for UC (22.8%). 52% of the CD patients were white, 42% were AA, and 6% were other. 42% of CD patients were male, with 58% were female. 6.1% (13 patients) of the 213 CD patients had a VTE. Of these 13 CD patients, 9 had active disease and 4 were in remission. 9 of 13 were female and 4 were male, with 5 white patients and 4 A A patients. 63 patients were diagnosed with UC, 3.38-fold fewer cases than CD. 25 UC patients were white, 25 were AA and 13 were in other ethnic groups. Of 63 UC cases, 2 UC patients had a VTE, both with active disease. At our institution, VTE appears to be 3x more frequently associated with CD than UC and was more common in white female patients. The recognition of VTE risk in CD, particularly in women, may be an important observation which may guide therapy and limit potentially life-threatening consequences. [ABSTRACT FROM AUTHOR]

Background: Dietetics practice educators are instrumental in the development of future dietitians. The present study aimed to explore dietetics practice educators' experiences of, and challenges faced in, dietetics workforce preparation. Methods: This study was guided by interpretive description methodology. Purposive and maximum variation sampling were used to recruit 18 dietetics practice educators from a variety of practice areas and locations across Australia. In‐depth, semi‐structured interviews were digitally recorded then transcribed verbatim and inductive coding of data was managed with nvivo (QSR International Pty Ltd, Doncaster, VIC, Australia). Multiple researchers analysed the data to develop preliminary themes using template analysis before final themes were identified. Results: Three main themes were developed: nurturing others; seeing the flaws; and soldiering on. Practice educators take great satisfaction in witnessing students develop and are focused on cultivating future practitioners with authentic learning activities. However, they are impacted by perceived shortcomings of the systems in which they operate and consider that broadening the scope of dietetics placements to better align with contemporary practice could benefit graduates and the profession. Despite these challenges, practice educators are pragmatic in getting on with their roles and recognise the advantages gained from student placements. Conclusions: Despite facing numerous challenges, practice educators derive benefits from their role in workforce preparation. Evidence is required on how students can demonstrate competence in contemporary areas of practice and on how to enable the scope of student placements to be broadened. Such strategies could support practice educators to overcome challenges and help ensure the dietetics profession of tomorrow is relevant and responsive. [ABSTRACT FROM AUTHOR]

Background: Dietetics students are a widely researched group. As emerging dietitians, they can provide valuable insights to inform how dietetics education programmes may be enhanced to meet contemporary healthcare needs. This review aimed to systematically synthesise dietetics students' experiences of dietetics workforce preparation. Methods: MEDLINE, CINAHL, Embase, PsycINFO, ERIC, Informit and ProQuest Dissertations and Theses Global were searched to identify research published until June 2017. Studies investigating dietetics students' experiences of dietetics workforce preparation, and employing qualitative data collection and analysis methods were included. Data analysis was guided by thematic synthesis, where themes were constructed through an iterative and inductive process. Study quality was appraised using the RATS Qualitative Research Review Guidelines. Results: From the 3301 records identified, five studies met the inclusion criteria and the views of 120 dietetics students from two countries over a 9‐year period were synthesised. The overarching theme of 'navigating through the ups and downs' was underpinned by four main themes: enduring hurdles; reconciling expectations; transforming self; and making and breaking connections. Quality appraisal results rated selection bias as being inadequate/inappropriate across all studies. Conclusions: Dietetics students undertake a transformational journey through dietetics education. They are inspired by seeing what is possible through meaningful encounters with practitioners in diverse settings. However, they are challenged by competitive environments and perceived ideals that are embedded in the profession. Strategies that focus on exposing dietetics students to inspirational practitioners, increasing and celebrating diversity in academic/placement settings, and incentivising collaboration across dietetics education, could act as catalysts to enhance the experience of future dietetics students and the nutrition‐related health of those they will serve. [ABSTRACT FROM AUTHOR]

X-ray grating interferometry is a powerful emerging tool in biomedical imaging, providing access to three complementary image modalities. In addition to the conventional attenuation modality, interferometry provides a phase modality, which visualizes soft tissue structures, and a dark-field modality, which relates to the number and size of sub-resolution scattering objects. A particularly strong dark-field signal originates from the alveoli or air sacs in the lung. Dark-field lung radiographs in animal models have already shown increased sensitivity in diagnosing lung diseases, such as lung cancer or emphysema, compared to conventional X-ray chest radiography. However, to date, X-ray dark-field lung imaging has either averaged information over several breaths or has been captured during a breath hold. In this paper, we demonstrate the first time-resolved dark-field imaging of a breath cycle in a mechanically ventilated mouse, in vivo, which was obtained using a grating interferometer. We achieved a time resolution of 0.1 s, visualizing the changes in the dark-field, phase, and attenuation images during inhalation and exhalation. These measurements show that the dark-field signal depends on the air volume and, hence, the alveolar dimensions of the lung. Conducting this type of scan with animal disease models would help to locate the optimum breath point for single-image diagnostic dark-field imaging and could indicate if the changes in the dark-field signal during breath provide a diagnostically useful complementary measure. [ABSTRACT FROM AUTHOR]

Objectives: Nuñoa, Peru has been the site of anthropological research on human adaptability, growth, and health since the 1960s. Previous studies documented a nascent secular trend in growth between 1964 and 1984. However, no secular trend was evident when the population was re‐examined in 1999, following an intervening period of sociopolitical upheaval. Subsequently, the region experienced considerable economic development reflected in secular increases in height. We seek to evaluate trends in growth and BMI among Nuñoan children over 50 years. Materials and methods: Anthropometric data for 929 children collected in 2015 are compared with anthropometric data for 394 children from 1964, 912 children from 1984, and 292 children from 1999. The data were converted to z‐scores using the WHO 2007 growth standards. anova is used to evaluate rates of stunting, underweight, overweight, and obesity across the study periods. Results: We observe small increases in stature and weight between the 1960s and 1980s, almost no change between the 1980s and 1990s and statistically significant reductions in stunting and increases in height between the 1990s and 2015. Discussion: There were relatively small differences in stature and weight and a high incidence of stunting between 1964 and 1999 attributed to extremely poor economic and health conditions. A large secular increase in height (7–8 cm on average) and consequent reduction in rates of stunting between 1999 and 2015 occurred due to improved social and economic conditions. In addition to political stabilization, enhanced infrastructure, social aid programs, improved healthcare, and economic expansion contribute to these trends. [ABSTRACT FROM AUTHOR]

The experimental circuit consisted of an i‐cor diagonal pump, a Medos Hilite 800 LT oxygenator, an 8Fr Biomedicus arterial cannula, a 10Fr Biomedicus venous cannula, and six feet of 1/4 in ID tubing for arterial and venous lines. The circuit was primed with lactated Ringer's solution and packed red blood cells (hematocrit 40%). Trials were conducted at various heart rates (90, 120, and 150 bpm) and flow rates (200, 400, and 600mL/min) under nonpulsatile and pulsatile mode with pulsatile amplitudes of 1000–4000rpm (1000 rpm increments). Real‐time pressure and flow data were recorded for analysis. The i‐cor pump was capable of creating nonpulsatile and electrocardiography (ECG)‐synchronized pulsatile flow, and automatically reducing pulsatile frequency by increasing the assist ratio at higher heart rates. Reduced pulsatile frequency led to lower hemodynamic energy generation but did not affect circuit pressure drop. Pulsatile flow delivered more hemodynamic energy to the pseudopatient when compared with nonpulsatile flow. The pump generated more hemodynamic energy with higher pulsatile amplitudes. The i‐cor pump can automatically adjust the pulsatile assist ratio to create pulsatile flow at higher heart rates, although this caused some hemodynamic energy loss. Compared with nonpulsatile flow, pulsatile flow generated and transferred more hemodynamic energy to the neonate during ECLS (200–600mL/min), especially at high pulsatile amplitudes and low flow rates. [ABSTRACT FROM AUTHOR]

Abstract Oxidative stress, specifically lipid peroxidation, is a major driving force in neurodegenerative processes. However, the exact role of lipid peroxidation remains elusive as reliable real-time detection and quantification of lipid peroxyl radicals proves to be challenging in vitro and in vivo. Motivated by this methodological limitation, we have optimized conditions for real-time imaging and quantification of lipid peroxyl radical generation in primary neuron cultures using the lipophilic fluorogenic antioxidant H 4 BPMHC (8-((6-hydroxy-2,5,7,8-tetramethylchroman-2-yl)-methyl)-1,5-di(3-chloropropyl)-pyrromethene fluoroborate), an α-tocopherol analog probe. By subjecting neurons to different antioxidant conditions in the presence and absence of lipid peroxidation inducing stressors (Haber-Weiss reagents), we maximized H 4 BPMHC sensitivity and confirmed its potential to temporally resolve subtle and marked differences in lipid peroxidation levels in real-time. Herein we report imaging and quantification of homeostatic and induced lipid peroxidation in primary neuron cultures, supporting the use of this probe for investigating healthy and diseased states. Overall these results provide the necessary foundation and impetus towards using H 4 BPMHC for elucidating and mapping lipid peroxyl radical contributions to ROS-associated pathological processes in neurons. Graphical abstract fx1 Highlights • Lipid peroxyl radicals were imaged and quantified real-time in primary neurons. • Antioxidant load impacted the rate of lipid peroxyl radical formation. • H 4 BPMHC has potential to detect subtle changes in lipid peroxyl radical levels. [ABSTRACT FROM AUTHOR]

Metal-induced hypersensitivity is driven by dendritic cells (DCs) that migrate from the site of exposure to the lymph nodes, upregulate costimulatory molecules, and initiate metal-specific CD4+ T cell responses. Chronic beryllium disease (CBD), a lifethreatening metal-induced hypersensitivity, is driven by beryllium-specific CD4+ Th1 cells that expand in the lung-draining lymph nodes (LDLNs) after beryllium exposure (sensitization phase) and are recruited back to the lung, where they orchestrate granulomatous lung disease (elicitation phase). To understand more about how beryllium exposures impact DC function during sensitization, we examined the early events in the lung and LDLNs after pulmonary exposure to different physiochemical forms of beryllium. Exposure to soluble or crystalline forms of beryllium induced alveolar macrophage death/release of IL-1α and DNA, enhanced migration of CD80hi DCs to the LDLNs, and sensitized HLA-DP2 transgenic mice after single low-dose exposures, whereas exposures to insoluble particulate forms beryllium did not. IL-1α and DNA released by alveolar macrophages upregulated CD80 on immature BMDC via IL-1R1 and TLR9, respectively. Intrapulmonary exposure of mice to IL-1R and TLR9 agonists without beryllium was sufficient to drive accumulation of CD80hi DCs in the LDLNs, whereas blocking both pathways prevented accumulation of CD80hi DCs in the LDLNs of beryllium-exposed mice. Thus, in contrast to particulate forms of beryllium, which are poor sensitizers, soluble or crystalline forms of beryllium promote death of alveolar macrophages and their release of IL-1α and DNA, which act as damage-associated molecular pattern molecules to enhance DC function during beryllium sensitization. [ABSTRACT FROM AUTHOR]

Background: Scant research disentangles the relationship between parenting competence, early intervention (EI) services, the family environment and informal support among fathers of children with developmental disabilities.Aims: (1) To determine the trajectory of parental competence for fathers of children with DD from age 3 to age 15. (2) Controlling for child and family characteristics, determine the main effects of the family environment, informal support, and EI services on paternal competence when their child with a developmental disability was age 3. (3) To determine whether there were lasting effects of the family environment, informal support, and the EI service system on differences in paternal competence over time.Methods: This study used multilevel modeling to analyze longitudinal data from 93 American fathers from the Early Intervention Collaborative Study.Results: There was no significant change over time in paternal competence after controlling for various covariates. Fathers who initially reported low levels of competence when their child was three reported continuously lower competence over time. Family relationships, positive supports, and perceived helpfulness of home visits were significant predictors of paternal competence at age three.Conclusion: Implications for programs and policy include developing and adopting rigorous ways to measure and carefully monitor service provision, including assessments of paternal competence, family relationships and informal supports at the start of early intervention, and fostering continuous collaborations between providers, researchers and clinicians to address challenges in data collection. [ABSTRACT FROM AUTHOR]

Captive rearing of wild brown kiwi (Apteryx mantelli) is widely carried out to assist in the recovery of this declining species. As a consequence, high densities of immunologically naïve kiwi are commonly housed in semi-captive conditions, with the potential to result in substantial morbidity and mortality from coccidiosis caused by multiple species of Eimeria. Previous research has described circadian variation in oocyst shedding across multiple avian host species. The aim of this research was to describe any circadian variation in oocyst shedding in brown kiwi. Droppings were collected from brown kiwi (n = 4) at a single captive rearing facility using video surveillance to determine the time of excretion, and oocyst counts were undertaken. Results show that two of the Eimeria spp. affecting brown kiwi exhibit a peak in oocyst shedding between 03.00 and 07.00 with few or no oocysts shed between 08.00 and midnight. These results are not able to be explained by the current hypotheses theorising the evolutionary forces behind the development of this adaptive trait. Our findings increase the current understanding of the biology of the Eimeria spp. affecting brown kiwi and have important implications for the management of captive-reared kiwi, in particular for the accurate interpretation of faecal oocyst counts. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To validate a method for measuring endotoxin‐core antibodies (EndoCAb) from dried blood spots (DBS)—drops of capillary whole blood collected and dried on filter paper—as an indicator of environmental enteropathy (EE) in infancy and early childhood. Methods: A commercially available enzyme immunoassay kit was adapted for use with DBS, with optimized steps for sample elution. Technical validation included analysis of linearity/recovery, precision and reliability, lower limit of detection, and correspondence between matched plasma and DBS samples. Validation in a field‐based setting was implemented with samples from Peruvian infants (n = 82; age = 2–33 months) collected at two time points six months apart. Results: A high correspondence between plasma and DBS levels of EndoCAb was observed (R2 = 0.93, P < .001). The lower limit of detection was found to be 0.01 GMU/mL. Interassay coefficient of variation (CV) was 10.9% and 8.06% for low and high controls, respectively. Mean intra‐assay CVs were 3.22% and 1.83%, respectively. In a sample of Peruvian infants, EndoCAb levels increased with age as expected (P < .001). Age explained nearly 34.6% of the variance in EndoCAb across the sample. Conclusion: These findings demonstrate the validity and feasibility of measuring EndoCAb in remote field settings using minimally invasive DBS sampling. [ABSTRACT FROM AUTHOR]

This investigation aimed to identify risk factors for lower extremity sprain/strain injuries in physically active men. Lower extremity (LE) sprain/strain injuries are a significant source of morbidity among physically active populations. Data on and risk factors for injuries, including personal characteristics, and physical training and fitness were obtained from male Soldiers in an operational US Army division (N=6,865) by survey. Injury risks, risk ratios (RR), odds ratios (OR), and 95% confidence intervals (95% CI) were calculated. Multivariate analysis utilized logistic regression. Self-reported injury incidence for the prior 12 months was 43% (n=2,939), with 30% (n=878) of injuries attributed to LE sprains/strains. Lower extremity sprain/strain injuries were most commonly caused by falls, jumps, trips, or slips (49.4%), occurred while running (30.6%), and often resulted in limited duty profiles (64%). Higher risk of LE sprain/strain injury was independently associated with higher body mass index (ORoverweight/normal=1.2, 95% CI: 1.0-1.5), (ORobese/normal=1.4, 95% CI: 1.1-1.9), lower aerobic endurance (from 2-mile run time) (ORQuartile 2 (Q2)/Quartile 4 (Q4)=1.4, 95% CI: 1.0-1.8), (ORQuartile 1 (Q1)/Q4=1.6, 95% CI: 1.3-2.1), and lower core strength (sit-up repetitions) (ORQ1/Q4=1.4, 95% CI: 1.1-1.8). Lower risk of LE sprain/strain injury was associated with performing unit resistance training 3 or more times per week (OR3 times/none=0.5, 95% CI: 0.3-0.8). LE sprain/strain injuries contribute a significant portion of injuries among US Army Soldiers. Emphasis on aerobic fitness, core strength, and resistance training may help reduce the risk of LE sprain/strain injury among physically active men. [ABSTRACT FROM AUTHOR]