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Abstract Introduction People living with HIV (PLHIV) have a 20-fold risk of tuberculosis (TB) disease compared to HIV-negative people. In 2021, the uptake of TB preventive treatment among the children and adolescents living with HIV at the Baylor-Uganda HIV clinic was 45%, which was below the national target of 90%. Minimal evidence documents the enablers and barriers to TB preventive treatment (TPT) initiation and completion among children and adolescents living with HIV(CALHIV). We explored the facilitators and barriers to TPT initiation and completion among CALHIV among adolescents aged 10-19years and caretakers of children below 18years. Methods We conducted a qualitative study from February 2022 to March 2023, at three paediatric and adolescent HIV treatment centers in Uganda. In-depth interviews were conducted at TPT initiation and after completion for purposively selected health workers, adolescents aged 10–19 years living with HIV, and caretakers of children aged below 18years. Results The desire to avoid TB disease, previous TB treatment, encouragement from family members, and ministry of health policies emerged as key facilitators for the children and adolescents to initiate TPT. Barriers to TPT initiation included; TB and HIV-related stigma, busy carer and adolescent work schedules, reduced social support from parents and family, history of drug side effects, high pill burden and fatigue, and perception of not being ill. TPT completion was enabled by combined TPT and ART refill visits, delivery of ART and TPT within the community, and continuous education and counseling from health workers. Reported barriers to TPT completion included TB and HIV-related stigma, long waiting time. Non-disclosure of HIV status by caretakers to CALHIV and fear of side effects was cited by health workers as a barrier to starting TPT. Facilitators of TPT initiation and completion reported by healthcare workers included patient and caretaker health education, counselling about benefits of TPT and risk of TB disease, having same appointment for TPT and ART refill to reduce patient waiting time, adolescent-friendly services, and appointment reminder phone calls. Conclusion The facilitators and barriers of TPT initiation and completion among CALHIV span from individual, to health system and structural factors. Health education about benefits of TPT and risk of TB, social support, adolescent-friendly services, and joint appointments for TPT and ART refill are major facilitators of TPT initiation and completion among CALHIV in Uganda.

Abstract Background Self-harm is a prevalent behaviour that has a major detrimental impact on a person’s life. Psychological therapies have the potential to help, but evidence of effective interventions remains limited. Access and acceptability of interventions can also be a significant challenge, with individuals either being unable to access help or having to endure long waiting lists. Cognitive analytic therapy (CAT) is a time-limited and relationally-focused psychotherapy that may provide a valuable treatment option for people who self-harm. This protocol outlines the methodology for the first feasibility randomised controlled trial (RCT) of CAT for adults that self-harm. The trial will aim to determine the feasibility, acceptability and safety of undertaking larger-scale evaluations of CAT for self-harm within an RCT context. Method An RCT design with 1:1 allocation to CAT plus treatment as usual (TAU) or TAU alone. Participants will be adult outpatients with three or more instances of self-harm in the past year (target sample of n = 60). CAT will be 8 one-to-one weekly 60-min sessions plus a follow-up session up to 8 weeks after the last session. Assessments will occur at baseline, 12 weeks and 18 weeks after randomisation. Qualitative interviews with participants will gain insights into the feasibility and acceptability of CAT. Feasibility outcomes will be judged against progression criteria. Discussion CAT may be an effective and accessible treatment option for people who self-harm, providing a more relationally orientated alternative to more behavioural therapies. The proposed feasibility RCT is an important first step in evaluating CAT as a treatment for self-harm. Trial registration The trial was pre-registered (21/10/22) on ISR CTN (ISRCTN code: ISRCTN75661422).

BackgroundPrevious studies investigating environmental and behavioral drivers of chronic disease have often had limited temporal and spatial data coverage. Smartphone-based digital phenotyping mitigates the limitations of these studies by using intensive data collection schemes that take advantage of the widespread use of smartphones while allowing for less burdensome data collection and longer follow-up periods. In addition, smartphone apps can be programmed to conduct daily or intraday surveys on health behaviors and psychological well-being. ObjectiveThe aim of this study was to investigate the feasibility and scalability of embedding smartphone-based digital phenotyping in large epidemiological cohorts by examining participant adherence to a smartphone-based data collection protocol in 2 ongoing nationwide prospective cohort studies. MethodsParticipants (N=2394) of the Beiwe Substudy of the Nurses’ Health Study 3 and Growing Up Today Study were followed over 1 year. During this time, they completed questionnaires every 10 days delivered via the Beiwe smartphone app covering topics such as emotions, stress and enjoyment, physical activity, access to green spaces, pets, diet (vegetables, meats, beverages, nuts and dairy, and fruits), sleep, and sitting. These questionnaires aimed to measure participants’ key health behaviors to combine them with objectively assessed high-resolution GPS and accelerometer data provided by participants during the same period. ResultsBetween July 2021 and June 2023, we received 11.1 TB of GPS and accelerometer data from 2394 participants and 23,682 survey responses. The average follow-up time for each participant was 214 (SD 148) days. During this period, participants provided an average of 14.8 (SD 5.9) valid hours of GPS data and 13.2 (SD 4.8) valid hours of accelerometer data. Using a 10-hour cutoff, we found that 51.46% (1232/2394) and 53.23% (1274/2394) of participants had >50% of valid data collection days for GPS and accelerometer data, respectively. In addition, each participant submitted an average of 10 (SD 11) surveys during the same period, with a mean response rate of 36% across all surveys (SD 17%; median 41%). After initial processing of GPS and accelerometer data, we also found that participants spent an average of 14.6 (SD 7.5) hours per day at home and 1.6 (SD 1.6) hours per day on trips. We also recorded an average of 1046 (SD 1029) steps per day. ConclusionsIn this study, smartphone-based digital phenotyping was used to collect intensive longitudinal data on lifestyle and behavioral factors in 2 well-established prospective cohorts. Our assessment of adherence to smartphone-based data collection protocols over 1 year suggests that adherence in our study was either higher or similar to most previous studies with shorter follow-up periods and smaller sample sizes. Our efforts resulted in a large dataset on health behaviors that can be linked to spatial datasets to examine environmental and behavioral drivers of chronic disease.

Coronary artery blood flow is influenced by various factors including vessel geometry, hemodynamic conditions, timing in the cardiac cycle, and rheological conditions. Multiple patterns of disturbed coronary flow may occur when blood flow separates from the laminar plane, associated with inefficient blood transit, and pathological processes modulated by the vascular endothelium in response to abnormal wall shear stress. Current simulation techniques, including computational fluid dynamics and fluid–structure interaction, can provide substantial detail on disturbed coronary flow and have advanced the contemporary understanding of the natural history of coronary disease. However, the clinical application of these techniques has been limited to hemodynamic assessment of coronary disease severity, with the potential to refine the assessment and management of coronary disease. Improved computational efficiency and large clinical trials are required to provide an incremental clinical benefit of these techniques beyond existing tools. This contemporary review is a clinically relevant overview of the disturbed coronary flow and its associated pathological consequences. The contemporary methods to assess disturbed flow are reviewed, including clinical applications of these techniques. Current limitations and future opportunities in the field are also discussed.

BackgroundControl of buffalo flies (Haematobia irritans exigua, BFs) relies mainly on chemical methods; however, resistance to insecticides is widespread in BF populations. Breeding for resistance to BFs represents a possible alternative, but direct phenotyping of animals is laborious and often inaccurate. The availability of reliable diagnostic biomarker(s) to identify low BF carrier cattle would facilitate rapid and accurate selection for genetic improvement. However, limited information is available regarding differences amongst cattle in host responses to BF infestation.MethodsThis study investigated the variation in Brangus cattle serum proteomic profiles before (naïve) and after peak BF exposure, in low (LF) and high BF burden (HF) cattle. Cattle were phenotyped for susceptibility based on BF counts on multiple dates using visual and photographic techniques. The relative abundance of serum proteins in cattle before and after exposure to BFs was analysed using sequential window acquisition of all theoretical fragment ion mass spectrometry (SWATH-MS).ResultsExposure to BFs elicited similar responses in HF and LF cattle, with 79 and 70 proteins, respectively, showing significantly different abundances post exposure as compared to their relevant naïve groups. The comparison of serum samples from naïve HF and LF cattle identified 44 significantly differentially abundant (DA) proteins, while 37 significantly DA proteins were identified from the comparison between HF and LF cattle post-exposure to BFs. Proteins with higher abundance in naïve LF cattle were enriched in blood coagulation mechanisms that were sustained after exposure to BFs. Strong immune response mechanisms were also identified in naïve LF cattle, whereas these responses developed in HF cattle only after exposure to BF. High BF cattle also showed active anticoagulation mechanisms in response to BF exposure, including downregulation of coagulation factor IX and upregulation of antithrombin-III, which might facilitate BF feeding.ConclusionUnderlying differences in the abundance of proteins related to blood coagulation and immune response pathways could potentially provide indirect indicators of susceptibility to BF infestation and biomarkers for selecting more BF-resistant cattle.

Summary: Background: Few studies have investigated the relationship between the food and physical activity environment and odds of gestational diabetes mellitus (GDM). This study quantifies the association between densities of several types of food establishments and fitness centers with the odds of having GDM. Methods: The density of supermarkets, fast-food restaurants, full-service restaurants, convenience stores and fitness centers at 500, 1000 and 1500 m (m) buffers was counted at residential addresses of 68,779 pregnant individuals from Eastern Massachusetts during 2000–2016. The ‘healthy food index’ assessed the relative availability of healthy (supermarkets) vs unhealthy (fast-food restaurants, convenience stores) food retailers. Multivariable logistic regression quantified the cross-sectional association between exposure variables and the odds of having GDM, adjusting for individual and area-level characteristics. Effect modification by area-level socioeconomic status (SES) was assessed. Findings: In fully adjusted models, pregnant individuals living in the highest density tertile of fast-food restaurants had higher GDM odds compared to those living in the lowest density tertile (500 m: odds ratio (OR):1.17 95% CI: [1.04, 1.31]; 1000 m: 1.33 95% CI: [1.15, 1.53]); 1500 m: 1.18 95% CI: [1.01, 1.38]). Greater residential density of supermarkets was associated with lower odds of GDM (1000 m: 0.86 95% CI: [0.74, 0.99]; 1500 m: 0.86 95% CI: [0.72, 1.01]). Similarly, living in the highest fitness center density tertile was associated with decreased GDM odds (500 m:0.87 95% CI: [0.76, 0.99]; 1500 m: 0.89 95% CI: [0.79, 1.01]). There was no evidence of effect modification by SES and no association found between the healthy food index and GDM odds. Interpretation: In Eastern Massachusetts, living near a greater density of fast-food establishments was associated with higher GDM odds. Greater residential access to supermarkets and fitness centers was associated with lower the odds of having GDM. Funding: NIH.

Background Depression is common among adolescents living with HIV (ALHIV) and impacts their quality of life. However, it is not routinely detected and treated due to a lack of screening tools, coupled with large numbers of clients in the HIV clinics and limited staff. Enabling adolescents to do a self-assessment for depression on a tablet computer could possibly improve the detection of depression in this population. We set out to assess the detection and referral of depression among ALHIV in care in Uganda.Methods This was a quasi-experimental study design with a historical control at Baylor College of Medicine of Children’s Foundation. We conducted a retrospective chart review of 425 adolescents covering a 3-month period and documented the proportion screened for depression and referred to the clinic counsellors. From July to September 2022, eligible adolescents aged 10–19 years who had assented and consented self-assessed for depression using a Patient Health Questionnaire-Adolescent on a tablet computer-assisted self-interview (CASI). Adolescents who screened positive had a prompt on the tablet computers referring them to the counsellor for mental healthcare. We compared the proportions of participants screened for depression and referred to counsellors from clinic chart review and on the CASI using paired t-tests.Results Out of 425 medical records reviewed, 54% (231/425) were females and the median age was 15 years. Of the participants who self-assessed on the CASI, 52% (222/425) were males and the median age of all participants was 16 years. Self-assessment on the CASI increased the rate of detection of depression from 0% to 23.3%. Of those referred on the CASI, 15% accessed care at the referral point.Conclusion The use of CASI improves the rate of detection of depression among ALHIV; however, there is a need to address the barriers to effective referral for mental health services.

Introduction: Protective associations of greenspace with Parkinson’s disease (PD) have been observed in some studies. Visual exposure to greenspace seems to be important for some of the proposed pathways underlying these associations. However, most studies use overhead-view measures (e.g., satellite imagery, land-classification data) that do not capture street-view greenspace and cannot distinguish between specific greenspace types. We aimed to evaluate associations of street-view greenspace measures with hospitalizations with a PD diagnosis code (PD-involved hospitalization). Methods: We created an open cohort of about 45.6 million Medicare fee-for-service beneficiaries aged 65 + years living in core based statistical areas (i.e. non-rural areas) in the contiguous US (2007–2016). We obtained 350 million Google Street View images across the US and applied deep learning algorithms to identify percentages of specific greenspace features in each image, including trees, grass, and other green features (i.e., plants, flowers, fields). We assessed yearly average street-view greenspace features for each ZIP code. A Cox-equivalent re-parameterized Poisson model adjusted for potential confounders (i.e. age, race/ethnicity, socioeconomic status) was used to evaluate associations with first PD-involved hospitalization. Results: There were 506,899 first PD-involved hospitalizations over 254,917,192 person-years of follow-up. We found a hazard ratio (95% confidence interval) of 0.96 (0.95, 0.96) per interquartile range (IQR) increase for trees and a HR of 0.97 (0.96, 0.97) per IQR increase for other green features. In contrast, we found a HR of 1.06 (1.04, 1.07) per IQR increase for grass. Associations of trees were generally stronger for low-income (i.e. Medicaid eligible) individuals, Black individuals, and in areas with a lower median household income and a higher population density. Conclusion: Increasing exposure to trees and other green features may reduce PD-involved hospitalizations, while increasing exposure to grass may increase hospitalizations. The protective associations may be stronger for marginalized individuals and individuals living in densely populated areas.

Abstract Urbanization has altered land surface properties driving changes in micro-climates. Urban form influences people’s activities, environmental exposures, and health. Developing detailed and unified longitudinal measures of urban form is essential to quantify these relationships. Local Climate Zones [LCZ] are a culturally-neutral urban form classification scheme. To date, longitudinal LCZ maps at large scales (i.e., national, continental, or global) are not available. We developed an approach to map LCZs for the continental US from 1986 to 2020 at 100 m spatial resolution. We developed lightweight contextual random forest models using a hybrid model development pipeline that leveraged crowdsourced and expert labeling and cloud-enabled modeling – an approach that could be generalized to other countries and continents. Our model achieved good performance: 0.76 overall accuracy (0.55–0.96 class-wise F1 scores). To our knowledge, this is the first high-resolution, longitudinal LCZ map for the continental US. Our work may be useful for a variety of fields including earth system science, urban planning, and public health.

Abstract The skin is the primary feeding site of ticks that infest livestock animals such as cattle. The highly specialised functions of skin at the molecular level may be a factor contributing to variation in susceptibility to tick infestation; but these remain to be well defined. The aim of this study was to investigate the bovine skin transcriptomic profiles of tick-naïve and tick-infested cattle and to uncover the gene expression networks that influence contrasting phenotypes of host resistance to ticks. RNA-Seq data was obtained from skin of Brangus cattle with high (n = 5) and low (n = 6) host resistance at 0 and 12 weeks following artificial tick challenge with Rhipicephalus australis larvae. No differentially expressed genes were detected pre-infestation between high and low resistance groups, but at 12-weeks there were 229 differentially expressed genes (DEGs; FDR

Lanostene-derived triterpenoids and β-glucans are important metabolites in Ganoderma mushrooms associated with benefits to human health. The medicinal value of the Australian Ganoderma species remains unclear, with no data on triterpenoid distribution or glucan content. In the present study, 22 Australian Ganoderma specimens were analyzed for triterpenoid and glucan contents. Thirty-two triterpenoids were identified in the fruiting bodies of 19 of the specimens. Distinct patterns in triterpenoid distribution between laccate and matte fruiting bodies were observed, leading to the classification of four groups of Ganoderma. Most of the glucans in the Ganoderma fruiting bodies were β-glucans (~99%), with a nominal α-glucan content (~1%). The β-glucan content ranged from 19.5 to 43.5% (w/w). A range of antioxidant activities was observed for methanol extracts using the ABTS (1.8 to 8.4 mg GAE.g−1), DPPH (1.7 to 9.4 mg GAE/g−1) and FRAP (24.7 to 111.6 mmol FeSO4.g−1) assays, with four specimens presenting relatively high radical scavenging and reducing activities. For the first time, we demonstrated that Australian Ganoderma mushrooms contain medicinal triterpenoids, including ganoderic acid A, and we established a link between its distribution and the fruiting body morphology. However, further research is required to isolate diploid clones and determine factors that impact triterpenoid and glucan synthesis in these strains.

Ocean acidification has become a major climate change concern requiring continuous observation. Additionally, in the industry, pH surveillance is of great importance. Consequently, there is a pressing demand to develop robust and inexpensive pH sensors. Ratiometric fluorescence pH sensing stands out as a promising concept. The application of carbon dots in fluorescent sensing presents a compelling avenue for the advancement of pH-sensing solutions. This potential is underpinned by the affordability of carbon dots, their straightforward manufacturing process, low toxicity, and minimal susceptibility to photobleaching. Thus, investigating novel carbon dots is essential to identify optimal pH-sensitive candidates. In this study, five carbon dots were synthesized through a simple solvothermal treatment, and their fluorescence was examined as a function of pH within the range of 5–9, across an excitation range of 200–550 nm and an emission range of 250–750 nm. The resulting optical features showed that all five carbon dots exhibited pH sensitivity in both the UV and visible regions. One type of carbon dot, synthesized from m-phenylenediamine, displayed ratiometric properties at four excitation wavelengths, with the best results observed when excited in the visible spectrum at 475 nm. Indeed, these carbon dots exhibited good linearity over pH values of 6–9 in aqueous Carmody buffer solution by calculating the ratio of the green emission band at 525 nm to the orange one at 630 nm (I525nm/I630nm), demonstrating highly suitable properties for ratiometric sensing.

BackgroundThe high case-fatality rates among children with tuberculosis (TB) are reportedly driven by in-hospital mortality and severe forms of TB. Therefore, there is need to better understand the predictors of mortality among children hospitalised with TB. We examined the patient clinical profiles, length of hospital stay from date of admission to date of final admission outcome, and predictors of mortality among children hospitalised with TB at two tertiary hospitals in Uganda.MethodsWe conducted a case-series study of children below 15 years of age hospitalised with TB, from January 1st, 2016, to December 31st, 2021. Convenience sampling was done to select TB cases from paper-based medical records at Mulago National Referral Hospital (MNRH) in urban Kampala, and Fort Portal Regional Referral Hospital (FRRH) in rural Fort Portal. We fitted linear and logistic regression models with length of stay and in-hospital mortality as key outcomes.ResultsOut of the 201 children hospitalised with TB, 50 were at FRRH, and 151 at MNRH. The male to female ratio was 1.5 with median age of 2.6 years (Interquartile range-IQR 1-6). There was a high prevalence of HIV (67/171, 39%), severe malnutrition reported as weight-for-age Z-score ConclusionsIn-hospital mortality was high, and significantly driven almost four times higher by TB meningitis, with longer hospital stay among children in urban hospitals. The high in-hospital mortality and long hospital stay may be reduced by timely TB diagnosis and treatment initiation among children.

Abdominal aortic aneurysms (AAAs) are relatively common, primarily among older men, and, in the case of rupture, are associated with high mortality. Although procedure-related morbidity and mortality have improved with the advent of endovascular repair, noninvasive treatment and improved assessment of AAA rupture risk should still be sought. Several cellular pathways seem contributory to the histopathologic changes that drive AAA growth and rupture. Hypoxia inducible factor 1-alpha (HIF-1α) is an oxygen-sensitive protein that accumulates in the cytoplasm under hypoxic conditions and regulates a wide array of downstream effectors to hypoxia. Examining the potential role of HIF-1α in the pathogenesis of AAAs is alluring, because local hypoxia is known to be present in the AAA vessel wall. A systematic scoping review was performed to review the current evidence regarding the role of HIF-1α in AAA disease in vivo. After screening, 17 studies were included in the analysis. Experimental animal studies and human studies show increased HIF-1α activity in AAA tissue compared with healthy aorta and a correlation of HIF-1α activity with key histopathologic features of AAA disease. In vivo HIF-1α inhibition in animals protects against AAA development and growth. One study reveals a positive correlation between HIF-1α–activating genetic polymorphisms and the risk of AAA disease in humans. The main findings suggest a causal role of HIF-1α in the pathogenesis of AAAs in vivo. Further research into the HIF-1α pathway in AAA disease might reveal clinically applicable pharmacologic targets or biomarkers relevant in the treatment and monitoring of AAA disease.

Abstract Background Widespread COVID-19 vaccine uptake can facilitate epidemic control. A February 2021 study in Uganda suggested that public vaccine uptake would follow uptake among leaders. In May 2021, Baylor Uganda led community dialogue meetings with district leaders from Western Uganda to promote vaccine uptake. We assessed the effect of these meetings on the leaders’ COVID-19 risk perception, vaccine concerns, perception of vaccine benefits and access, and willingness to receive COVID-19 vaccine. Methods All departmental district leaders in the 17 districts in Western Uganda, were invited to the meetings, which lasted approximately four hours. Printed reference materials about COVID-19 and COVID-19 vaccines were provided to attendees at the start of the meetings. The same topics were discussed in all meetings. Before and after the meetings, leaders completed self-administered questionnaires with questions on a five-point Likert Scale about risk perception, vaccine concerns, perceived vaccine benefits, vaccine access, and willingness to receive the vaccine. We analyzed the findings using Wilcoxon’s signed-rank test. Results Among 268 attendees, 164 (61%) completed the pre- and post-meeting questionnaires, 56 (21%) declined to complete the questionnaires due to time constraints and 48 (18%) were already vaccinated. Among the 164, the median COVID-19 risk perception scores changed from 3 (neutral) pre-meeting to 5 (strong agreement with being at high risk) post-meeting (p

Abstract Background Going to university is an important milestone in many people’s lives. It can also be a time of significant challenge and stress. There are growing concerns about mental health amongst student populations including suicide risk. Student mental health and counselling services have the potential to prevent suicide, but evidence-based therapies are required that fit these service contexts. The Broad-Minded Affective Coping intervention (BMAC) is a brief (6 sessions), positive imagery-based intervention that aims to enhance students access to past positive experiences and associated emotions and cognitions. Pilot data provides preliminary support for the BMAC for students struggling with suicidal thoughts and behaviours, but this intervention has not yet been evaluated in the context of a randomised controlled trial (RCT). The Mental Imagery for Suicidality in Students Trial (MISST) is a feasibility RCT that aims to determine the acceptability and feasibility of evaluating the BMAC as an intervention for university students at risk of suicide within a larger efficacy trial. Key feasibility uncertainties have been identified relating to recruitment, retention, and missing data. Intervention acceptability and safety will also be evaluated. Method MISST is a feasibility randomised controlled trial design, with 1:1 allocation to risk assessment and signposting plus BMAC or risk assessment and signposting alone. Participants will be university students who self-report experiences of suicidal ideation or behaviour in the past 3 months. Assessments take place at baseline, 8, 16, and 24 weeks. The target sample size is 66 participants. A subset of up to 20 participants will be invited to take part in semi-structured qualitative interviews to obtain further data concerning the acceptability of the intervention. Discussion The BMAC intervention may provide an effective, brief talking therapy to help university students struggling with suicidal thoughts that could be readily implemented into university student counselling services. Depending on the results of MISST, the next step would be to undertake a larger-scale efficacy trial. Trial registration The trial was preregistered (17 December 2021) on ISRCTN (ISRCTN13621293) and ClinicalTrials.gov (NCT05296538).

Abstract Stratospheric Aerosol Geoengineering (SAG) is proposed to offset global warming; however, the use of this approach can an impact on the hydrological cycle. We used simulations from Coupled Model Intercomparison Project (CMIP5) and Geoengineering Model Intercomparison Project (G3 simulation) to analyze the impacts of SAG on precipitation (P) and to determine its responsible causes in West Africa and Sahel region. CMIP5 historical data were first validated, the results obtained are consistent with observational data. Under the Representative Concentration Pathway scenario RCP4.5, a slight increase is found in the West Africa Region relative to present‐day climate. The dynamic processes especially, the monsoon shifts are responsible for this precipitation change. Under RCP4.5, during the monsoon period, reductions in P are 0.86%, 0.80% relative to the present‐day climate in the Northern and Southern Sahel, respectively, while precipitation is increased by 1.04% in the West African Region. Under SAG, we find a 3.71% decrease of precipitation in the West African Region while the precipitation decrease is 17.4% and 8.47% respectively in the North Sahel and South Sahel. This decrease in monsoon precipitation is mainly explained by changes in dynamics, which lead to weakened monsoon circulation and a shift in the distribution of monsoon precipitation. This result suggests that SAG deployment to balance all warming can be harmful to rainfall in WAR if the amount of SO2 to be injected into this tropical area is not taken into consideration.

Introduction: Most climate-health studies focus on temperature; however, less is known about health effects of exposure to atmospheric moisture. Humid air limits sweat evaporation from the body and can in turn exert strain on the cardiovascular system. We evaluated associations of long-term exposure to summer specific humidity with cardiovascular disease (CVD), coronary heart disease (CHD) and cerebrovascular disease (CBV) hospitalization. Methods: We built an open cohort consisting of ∼63 million fee-for-service Medicare beneficiaries, aged ≥65, living in the contiguous US (2000–2016). We assessed zip code level summer average specific humidity and specific humidity variability, based on daily estimates from the Gridded Surface Meteorological dataset (∼4km spatial resolution). To estimate associations of summer specific humidity with first CVD, CHD, and CBV hospitalization, we used Cox-equivalent Poisson models adjusted for individual and area-level socioeconomic status indicators, temperature, and winter specific humidity. Results: Higher summer average specific humidity was associated with an increased risk of CVD, CHD, and CBV hospitalization. We found hazard ratios (HRs) of 1.07 (95%CI: 1.07, 1.08) for CVD hospitalization, 1.08 (95%CI: 1.08, 1.09) for CHD hospitalization, and 1.07 (95%CI: 1.07, 1.08) for CBV hospitalization per IQR increase (4.0 g of water vapor/kg of dry air) in summer average specific humidity. Associations of summer average specific humidity were strongest for beneficiaries eligible for Medicaid and for beneficiaries with an unknown or other race. Higher summer specific humidity variability was also associated with increased risk of CVD, CHD, and CBV hospitalization. Associations were not affected by adjustment for temperature and regions of the US, as well as exclusion of potentially prevalent cases. Conclusion: Long-term exposure to higher summer average specific humidity and specific humidity variability were positively associated with CVD hospitalization. As global warming could increase humidity levels, our findings are important to assess potential health impacts of climate change.

Abstract Deficits in protein synthesis are associated with Parkinson’s disease (PD). However, it is not known which proteins are affected or if there are synthesis differences between patients with sporadic and Leucine-Rich Repeat Kinase 2 (LRRK2) G2019S PD, the most common monogenic form. Here we used bio-orthogonal non-canonical amino acid tagging for global analysis of newly translated proteins in fibroblasts from sporadic and LRKK2-G2019S patients. Quantitative proteomic analysis revealed that several nascent proteins were reduced in PD samples compared to healthy without any significant change in mRNA levels. Using targeted proteomics, we validated which of these proteins remained dysregulated at the static proteome level and found that regulators of endo-lysosomal sorting, mRNA processing and components of the translation machinery remained low. These proteins included autophagy-related protein 9A (ATG9A) and translational stability regulator YTH N6-ethyladenosine RNA binding protein 3 (YTHDF3). Notably, 77% of the affected proteins in sporadic patients were also repressed in LRRK2-G2019S patients (False discovery rate (FDR)

Measurement(s) park Technology Type(s) Geographic Information System Sample Characteristic - Environment County • Tract Sample Characteristic - Location United States

The COVID-19 pandemic spread between neighboring countries through land, water, and air travel. Since May 2020, ministries of health for the Democratic Republic of the Congo, Tanzania, and Uganda have sought to clarify population movement patterns to improve their disease surveillance and pandemic response efforts. Ministry of Health–led teams completed focus group discussions with participatory mapping using country-adapted Population Connectivity Across Borders toolkits. They analyzed the qualitative and spatial data to prioritize locations for enhanced COVID-19 surveillance, community outreach, and cross-border collaboration. Each country employed varying toolkit strategies, but all countries applied the results to adapt their national and binational communicable disease response strategies during the pandemic, although the Democratic Republic of the Congo used only the raw data rather than generating datasets and digitized products. This 3-country comparison highlights how governments create preparedness and response strategies adapted to their unique sociocultural and cross-border dynamics to strengthen global health security.

Global climate change has sparked efforts to adapt to increasing temperatures, especially in urban areas that experience increased day and nighttime temperatures due to the urban heat island effect. The addition of greenspace has been suggested as a possible means for urban centers to respond to increasing urban temperatures. Thus, it is important for urban planning and policymakers to have access to data on greenspace specific at a fine spatial resolution. This dataset consists of information on peak and annual average 1 × 1 km Normalized Difference Vegetation Index (NDVI) for over 1,000 global urban centers, which is an objective satellite-based measure of vegetation. Population-weighted values for both peak and annual average NDVI and include an indicator of greenness, with seven levels ranging from extremely low to extremely high are provided. Additional information regarding the climate zone (using the Köppen-Geiger climate classification) and level of development (using the Human Development Index or HDI) for each city is included. Analyses were repeated in 2010, 2015, and 2020 to provide the ability to track urban greenness over time. Data are provided in tabular format with summaries presented in both tables and graphics. These data can be used to inform policy and planning and can be used as an indicator for a variety of climate and health investigations.

The aim of this work is to create a new type of gravimeter that can function effectively in the challenging conditions of space, specifically on the surfaces of planets and moons. The proposed device, called a diamagnetically stabilized magnetically levitated gravimeter (DSMLG), uses magnetic forces to balance a test mass against the force of gravity, allowing for accurate measurements. A diamagnetically stabilized levitation structure comprises a floating magnet, diamagnetic material, and a lifting magnet. The floating magnet levitates between two diamagnetic plates without the need for external energy input due to the interaction between the magnetic forces of the floating magnet and the stabilizing force of the diamagnetic material. This structure allows for stable levitation of the floating magnet without requiring additional energy. The goal is to design a gravimeter that is lightweight, requires minimal power, can withstand extreme temperatures and shocks, and has a low data rate. The authors envision this gravimeter being used on various robotic spacecraft, such as landers and rovers, to study the interiors of rocky and icy celestial bodies. This paper reports on the results of a finite element model analysis of the DSMLG and the strength of the resulting diamagnetic spring. The findings contribute to the understanding of the levitation characteristics of diamagnetically stabilized structures and provide valuable insights for their practical applications, including in the development of the proposed DSMLG.

Abstract In vitro production (IVP) of embryos in cattle can result in large/abnormal offspring syndrome (LOS/AOS) which is characterized by macrosomia. LOS can cause dystocia and lead to the death of dam and calf. Currently, no test exists to identify LOS pregnancies. We hypothesized that fetal ultrasonography and/or maternal blood markers are useful to identify LOS. Bovine fetuses were generated by artificial insemination (control) or IVP. Fetal ultrasonographies were taken on gestation D55 (D55) and fetal collections performed on D56 or D105 (gestation in cattle ≈ D280). IVP fetuses weighing ≥ 97 percentile of the control weight were considered LOS. Ultrasonography results show that the product of six D55 measurements can be used to identify extreme cases of LOS. To determine whether maternal blood can be used to identify LOS, leukocyte mRNA from 23 females was sequenced. Unsupervised hierarchical clustering grouped the transcriptomes of the two females carrying the two largest LOS fetuses. Comparison of the leukocyte transcriptomes of these two females to the transcriptome of all other females identified several misregulated transcripts on gestation D55 and D105 with LOC783838 and PCDH1 being misregulated at both time-points. Together our data suggest that LOS is identifiable during pregnancy in cattle.

Abstract Background Disease emergence and production loss caused by cattle tick infestations have focused attention on genetic selection strategies to breed beef cattle with increased tick resistance. However, the mechanisms behind host responses to tick infestation have not been fully characterised. Hence, this study examined gene expression profiles of peripheral blood leukocytes from tick-naive Brangus steers (Bos taurus x Bos indicus) at 0, 3, and 12 weeks following artificial tick challenge experiments with Rhipicephalus australis larvae. The aim of the study was to investigate the effect of tick infestation on host leukocyte response to explore genes associated with the expression of high and low host resistance to ticks. Results Animals with high (HR, n = 5) and low (LR, n = 5) host resistance were identified after repeated tick challenge. A total of 3644 unique differentially expressed genes (FDR

IntroductionBreeding for tick resistance is a sustainable alternative to control cattle ticks due to widespread resistance to acaricidal drugs and the lack of a protective vaccine. The most accurate method used to characterise the phenotype for tick resistance in field studies is the standard tick count, but this is labour-intensive and can be hazardous to the operator. Efficient genetic selection requires reliable phenotyping or biomarker(s) for accurately identifying tick-resistant cattle. Although breed-specific genes associated with tick resistance have been identified, the mechanisms behind tick resistance have not yet been fully characterised.MethodsThis study applied quantitative proteomics to examine the differential abundance of serum and skin proteins using samples from naïve tick-resistant and -susceptible Brangus cattle at two-time points following tick exposure. The proteins were digested into peptides, followed by identification and quantification using sequential window acquisition of all theoretical fragment ion mass spectrometry.ResultsResistant naïve cattle had a suite of proteins associated with immune response, blood coagulation and wound healing that were significantly (adjusted P < 10- 5) more abundant compared with susceptible naïve cattle. These proteins included complement factors (C3, C4, C4a), alpha-1-acid glycoprotein (AGP), beta-2-glycoprotein-1, keratins (KRT1 & KRT3) and fibrinogens (alpha & beta). The mass spectrometry findings were validated by identifying differences in the relative abundance of selected serum proteins with ELISA. The proteins showing a significantly different abundance in resistant cattle following early and prolonged tick exposures (compared to resistant naïve) were associated with immune response, blood coagulation, homeostasis, and wound healing. In contrast, susceptible cattle developed some of these responses only after prolonged tick exposure.DiscussionResistant cattle were able to transmigrate immune-response related proteins towards the tick bite sites, which may prevent tick feeding. Significantly differentially abundant proteins identified in this research in resistant naïve cattle may provide a rapid and efficient protective response to tick infestation. Physical barrier (skin integrity and wound healing) mechanisms and systemic immune responses were key contributors to resistance. Immune response-related proteins such as C4, C4a, AGP and CGN1 (naïve samples), CD14, GC and AGP (post-infestation) should be further investigated as potential biomarkers for tick resistance.

Haematobia irritans exigua, commonly known as buffalo fly, is the major hematophagous ectoparasite of north Australian cattle herds. Lesions associated with buffalo fly infestation are generally alopecic, hyperkeratotic, or scab encrusted wounds with variable hemorrhagic ulceration. Buffalo flies can transmit a filarial nematode, Stephanofilaria sp., which has been implicated in the pathogenesis of buffalo fly lesions, but Stephanofilaria infection has not been detected in all lesions suggesting that other causal factors may be involved. This study characterized the pathology of buffalo fly lesions to identify the role of Stephanofilaria in lesion development, as well as to identify other potential agents. Lesion biopsies were collected from north and south Queensland and tested for the presence of Stephanofilaria by qPCR. Each lesion was scored grossly (0–4) for hemorrhage, ulceration, exudation, and alopecia. Lesions were also scored microscopically (0–4) for epidermal and dermal damage and inflammatory characters. Stephanofilaria infection was detected in 31% of lesion biopsies. Grossly, Stephanofilaria-infected lesions had significantly larger lesion area and higher scores for alopecia and hyperkeratosis than lesions where no nematodes were found (P < 0.05). Histologically, epidermal, dermal, and adnexal damage was significantly higher in Stephanofilaria infected lesions than lesions without nematodes. Eosinophils, macrophages, and lymphocytes were significantly more abundant in Stephanofilaria positive lesions as compared to negative lesions. This study also noted bacterial infection with colonies of coccoid bacteria, observed in skin sections from 19 lesions. Grossly, lesions with bacterial infection had significantly higher ulceration scores compared to Stephanofilaria positive lesions, and histologically epidermal disruption was significantly greater in bacteria-infected lesions. We found no evidence of bacteria or Stephanofilaria infection in 49% of the lesions assessed and tissue damage patterns and eosinophilic inflammation suggested hypersensitivity to buffalo fly feeding as a possible cause of these lesions. These findings suggest that although the presence of Stephanofilaria infection may increase the severity of lesion pathology, it is not essential for lesion development. These outcomes also suggest a potential role of bacteria and hypersensitivity in pathogenesis of some lesion. A better understanding of buffalo fly lesion etiology will contribute to the optimal treatment and control programmes.

Abstract Energy and humanitarian action have long been uneasy bedfellows. In the field, many humanitarian practitioners lack the time or remit to engage with a complex issue such as energy, and the topic to date has received relatively little attention from the private, development and academic sectors. This paper hopes to provide more clarity on energy in forced displacement settings by analysing how energy is interwoven with the humanitarian cluster system. This paper has two aims: (1) to assess existing evidence in the sector and explain the links between energy and each of the humanitarian clusters and (2) to provide recommendations on how humanitarian response efforts can transition from informal action to a comprehensive response on sustainable energy provision. This paper is the first to investigate the role of energy using the cluster system as a framework and contributes to a rapidly evolving field of research and practice on energy in humanitarian contexts. Our analysis demonstrates that energy is not fully integrated within humanitarian programme planning. Further, it highlights pathways for improving humanitarian outcomes enabled by improved energy practices. We identify ten ways clusters can integrate action on energy to support crisis-affected communities.

Abstract Smartphones are now nearly ubiquitous; their numerous built-in sensors enable continuous measurement of activities of daily living, making them especially well-suited for health research. Researchers have proposed various human activity recognition (HAR) systems aimed at translating measurements from smartphones into various types of physical activity. In this review, we summarized the existing approaches to smartphone-based HAR. For this purpose, we systematically searched Scopus, PubMed, and Web of Science for peer-reviewed articles published up to December 2020 on the use of smartphones for HAR. We extracted information on smartphone body location, sensors, and physical activity types studied and the data transformation techniques and classification schemes used for activity recognition. Consequently, we identified 108 articles and described the various approaches used for data acquisition, data preprocessing, feature extraction, and activity classification, identifying the most common practices, and their alternatives. We conclude that smartphones are well-suited for HAR research in the health sciences. For population-level impact, future studies should focus on improving the quality of collected data, address missing data, incorporate more diverse participants and activities, relax requirements about phone placement, provide more complete documentation on study participants, and share the source code of the implemented methods and algorithms.

Introduction The burden of Alzheimer’s disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of—and disparities in—cognitive decline and dementia.Methods and analyses We describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing.Ethics and dissemination This project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.

Background: Light at night (LAN) may alter estrogen regulation through circadian disruption. High levels of outdoor LAN may increase breast cancer risk, but studies have largely not considered possible residual confounding from correlated environmental exposures. We evaluated the association between indoor and outdoor LAN and incident breast cancer. Methods: In 47,145 participants in the prospective Sister Study cohort living in the contiguous U.S., exposure to outdoor LAN was determined using satellite-measured residential data and indoor LAN was self-reported (light/TV on, light from outside the room, nightlight, no light). We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between outdoor and indoor LAN and breast cancer risk. Models were adjusted for age, race/ethnicity, educational attainment, annual household income, neighborhood disadvantage, latitude, and population density as a proxy for urbanicity. To evaluate the potential for residual confounding of the outdoor LAN and breast cancer relationship by factors associated with urbanicity, we considered further adjustment for exposures correlated with outdoor LAN including NO2 [Spearman correlation coefficient, rho (ρ) = 0.78], PM2.5 (ρ = 0.36), green space (ρ = − 0.41), and noise (ρ = 0.81). Results: During 11 years of follow-up, 3,734 breast cancer cases were identified. Outdoor LAN was modestly, but non-monotonically, associated with a higher risk of breast cancer (Quintile 4 vs 1: HR = 1.10, 95% CI: 0.99–1.22; Quintile 5 vs 1: HR = 1.04, 95% CI: 0.93–1.16); however, no association was evident after adjustment for correlated ambient exposures (Quintile 4 vs 1: HR = 0.99, 95% CI: 0.86–1.14; Quintile 5 vs 1: HR = 0.89, 95% CI: 0.74–1.06). Compared to those with no indoor LAN exposure, sleeping with a light or TV on was associated with a HR = 1.09 (95% CI: 0.97–1.23) in the adjusted model. Conclusions: Outdoor LAN does not appear to increase the risk of breast cancer after adjustment for correlated environmental exposures.

Exposure to natural greenspace benefits health through direct and indirect pathways: increasing physical activity, improving mental health, relieving social isolation, reducing exposure to extreme temperature, noise, and air pollution. Understanding the etiologic pathway of greenspace and health is needed. Here, we used a large cohort follow-up data from the U.K. Biobank to quantify the magnitude of behavioural factors, psychological factors, biomarkers/physiological measurements, co-morbid diseases, and environmental exposure as potential mediators in the relationship between greenspace and mortality. We estimated hazard ratios (HR) with Cox proportional hazards models, and undertook exploratory mediation analyses to quantify the relative contribution of five types of mediators. Our results indicate greenspace was strongly associated with lower mortality risks [per IQR of public greenspace (HR = 0.90 (95% CI 0.86-0.84)) and domestic gardens (HR = 0.91, (95% CI 0.88–0.94))]. The protective associations were especially pronounced among those with lower individual-level socioeconomic status or living in places with area-level deprivation. Exploratory mediation analysis detected benefits in pathways through reducing air pollution, relieving social isolation and depression, increased physical activity and time spent outdoor, better lung function (FEV1/FVC), and having higher serum vitamin D levels.

The use of black soldier fly larvae (BSFL) grown on different organic waste streams as a source of feed ingredient is becoming very popular in several regions across the globe. However, information about the easy-to-use methods to monitor the safety of BSFL is a major step limiting the commercialization of this source of protein. This study investigated the ability of near infrared (NIR) spectroscopy combined with chemometrics to predict yeast and mould counts (YMC) in the feed, larvae, and the residual frass. Partial least squares (PLS) regression was employed to predict the YMC in the feed, frass, and BSFL samples analyzed using NIR spectroscopy. The coefficient of determination in cross validation (R2CV) and the standard error in cross validation (SECV) obtained for the prediction of YMC for feed were (R2cv: 0.98 and SECV: 0.20), frass (R2cv: 0.81 and SECV: 0.90), larvae (R2cv: 0.91 and SECV: 0.27), and the combined set (R2cv: 0.74 and SECV: 0.82). However, the standard error of prediction (SEP) was considered moderate (range from 0.45 to 1.03). This study suggested that NIR spectroscopy could be utilized in commercial BSFL production facilities to monitor YMC in the feed and assist in the selection of suitable processing methods and control systems for either feed or larvae quality control.

This study investigated the role of cattle immune responses in the pathogenesis of buffalo fly (Haematobia irritans exigua) (BF) lesions. Brangus steers phenotyped for lesion development were divided into three groups: high lesion susceptibility (HL), low lesion susceptibility (LL) and no lesions (NL), based on lesion severity scores. Each steer was injected intradermally with different concentrations of BF, Onchocerca gibsoni (Og), and Musca domestica (Md) antigens. At 1 h post-injection, wheal areas at BF injection sites were found to be significantly larger in HL than NL cattle, but there were no significant differences (p < 0.05) found between either the HL or NL cattle and LL cattle. At 24, 48, and 72 h post-injection, the skinfold thickness response to both BF and Md antigens was significantly greater in the HL group than the NL group. However, skin thickness was significantly greater for the BF antigens than the Md antigens (p < 0.05). There were no significant differences found between the LL and NL animals in response to the BF antigens at any time, and no significant differences were determined between any of the lesion groups in response to the Og antigens. Histological examination of skin sections taken from the BF antigen injection sites in HL cattle at 72 h post-injection revealed necrosis of the epidermis and superficial dermis, along with severe eosinophilic inflammation. This study suggests that differences in the hypersensitivity to BF antigens underlie differences amongst the cattle in their susceptibility to the development of BF lesions, and breeding for immune-related biomarkers may assist in selecting more BF lesion-resistant cattle.