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Background & aims: Malnutrition is related with pulmonary disease. The aim was to analyze the association of lung function respectively to nutritional status, identified pulmonary pathogens and socioeconomic condition of patients attending a pediatric CF reference center. Methods: Cross-sectional study performed with CF patients aged 6 to 18 years attending a CF-Center in southern Brazil. Nutritional status, plasma albumin level and pulmonary bacterial colonization were assessed. The outcome studied was forced expiratory volume in 1 second (FEV1). Results: Eighty-five patients were included in this study. FEV1 was significantly associated with body mass index (BMI) percentiles, plasma albumin level and methicillin resistant Staphylococcus aureus (MRSA) pulmonary colonization. Regression analysis showed that BMI below the 10th percentile was associated with a 25.58% drop in FEV1, and plasma albumin levels equal to or lower than 4.1 mg/dL was associated with 18.6% FEV1 reduction. FEV1 was 14.4% lower in the MRSA infected patients. Plasma albumin of 4.25 mg/dL predicted FEV1 of 60% with 76.9% sensitivity and 72.2% specificity, and 85.7% accuracy. The socioeconomic status was not association with pulmonary function. Conclusion: BMI below the 10th percentile and albumin below 4.1 mg/dL were predictors of low FEV1. Chronic MRSA infection was associated with lower FEV1. Longitudinal studies may better complement these results.Objetivos: Analizar la asociación entre la función pulmonar y tres factores: el estado nutricional, el estado de patógenos pulmonares y el estado socio-económico de pacientes en un centro de referencia en atención a pacientes pediátricos con fibrosis quística. Métodos: Se realizó un estudio longitudinal en pacientes con fibrosis quística, de 6 a 18 años atendidos en un centro de fibrosis quística del Sur del Brasil. Fueron evaluados: estado nutricional, niveles de albúmina plasmática y colonización bacteriana pulmonar. El principal resultado estudiado fue el volumen espiratorio forzado en el 1 segundo (FEV1). Resultados: Fueron incluidos en este estudio 85 pacientes. El FEV1 se mostró significativamente correlacionado con percentiles del Índice de Masa Corporal (IMC), albúmina plasmática y colonización pulmonar por Staphylococcus aureus resistente a meticilina (SARM). El análisis de regresión mostró que el IMC abajo del percentil 10 estuvo asociado con una disminución del 25,58% en el FEV1, y que niveles de albúmina plasmática iguales o menores a 4,1 mg/dL se correlacionaron on una reducción de 18,6% del FEV1. El FEV1 fue 14,4% menos en los pacientes infectados por SARM. La albúmina plasmática de 4,25 mg/dL predijo un FEV1 de 60% con una sensibilidad de 76,9% una especificidad de 72,2% y precisión de 85,7%. El estado socioeconómico no tuvo asociación con la función pulmonar. Conclusiones: El IMC debajo del percentil 10 y albúmina plasmática menor que 4,1 mg/dL fueron predictivos de un bajo FEV1 . La infección crónica de SARM mostró asociación con un menor FEV1.

Migration is an essential life stage in many species, but is little understood in some groups, e.g. storm-petrels. Considering that storm-petrels reside in non-breeding areas for over half of their lifespan, identifying these areas is a priority for conservation efforts. Townsend’s Hydrobates socorroensis and Ainley’s storm-petrels H. cheimomnestes are 2 threatened sister species, breeding allochronically on Guadalupe Island (Mexican Pacific), for which migratory patterns are unknown. In this article, we describe the non-breeding areas of these 2 species, assess artificial light events recorded by geolocators, and describe the birds’ daily activity patterns. We deployed geolocators from 2021 to 2023 and modeled migratory routes using SGAT. We successfully tracked 7 Townsend’s and 4 Ainley’s storm-petrels over their non-breeding period. Townsend’s storm-petrels were found to travel to the south of the Baja California Peninsula and spent most of the time in Mexican waters, while Ainley’s storm-petrels migrated toward Hawaii and spent most of the time on the high seas. For the Townsend’s storm-petrels, 16.1% of their core areas are in protected waters, whereas for Ainley’s storm-petrel, only 0.7% of the core areas are protected, and 0.8% of those areas are recognized as key biodiversity areas (KBAs). Further, our findings indicate that both species are mainly nocturnal, making them highly susceptible to the impacts of light pollution; we detected 6 artificial light events. Our findings also support the hypothesis that divergence in the migration patterns between allochronic populations could be a crucial factor in sympatric speciation, which seems likely in seasonal environments like the northern Pacific.

RESUMO: Apresentamos o caso clínico de um doente de vinte e urn anos, sexo masculino, raça branca, toxicodependente, que se queixou, no Serviço de Urgência, de febre, emagrecimento, dor abdominal e diarreia. Foi excluído o diagnóstíco inicial de apendicite. Baseados nos estudos radiológicos e endoscópicos, foi feito o diagnóstico de doença de Crohn ileo-cecal e iniciado tratamento com ácido 5-aminosalicílico e corticosteroides. Dada a má resposta clínics, foi adicionada 5-mercaptopurina. Seis semanas mais tarde. o doente ficou neutropénico e a febre reapareceu. Os radiogramas e tomografia computadorizada (TC) revelaram um derrame pleural direito e uma lesão cavitada nodular no segmento posterior do lobo superior do pulmão direito. Foi realizada uma biópsia pleural e foram identificados bacilos álcool-ácido resistentes (BAAR). Foi iniciado tratamento específico para a tuberculose e as imagens pulmonares desapareceram, mas a febre e as dores abdominais persistiram.Após varios procedimentos diagnósticos, foi necessário realizar uma laparotomia. Foi confirmada uma ileíte terminal com fistula para o cólon sigmoide e feita uma colectomia parcial. Tinha adenomegalias meseotéricas nas quais foram identificados BAAR. O doente cumpriu dez meses de tratamento antibacilar e encontra-se bem.REV PORT PNEUMOL 1999; V (4): 427-434 ABSTRACT: We present the case report of a twenty one years old white male drug addict who complained in the Emergency Departement of fever, weight loss, abdominal pain and diarrhea. A first diagnosis of appendicitis was excluded. Based on radiologic and endoscopic studies a diagnosis of Crohnâs ileocecal disease was achieved and a treatment with 5-amino-salicilic acid and corticosteroid was started. There was a poor clinical response so 5-mercaptopurine was added. Six weeks later be became neutropenic and fever relapsed. The chest X- rays and computer tomogram (CT) revealed a right pleural effusion and a nodular cavitated lesion in the posterior segment of the upper right lung lobe. A pleural biopsy was performed and acid fast bacilii (AFB) were seen. Specific treatment for tuberculosis was started. The lung findings resolved but fever and abdominal pain persisted. After several diagnostic procedures a laparotomy was required. A terminal ileitis with a fistulous comunication to the sigmoid colon was confirmed and a partial colectomy was done. There was mesenteric lymph node enlargement and AFB ewere identified on biopsy material. The patient remains free of disease after 10 months.REV PORT PNEUMOL 1999; V (4): 427-434 Key-words: Terminal ileitis, Crohnâs disease, intestinal tuberculosis: multisistemic tuberculosis, : Palavras-chave, Ileite terminal, doença de Crohn, tuberculose intestinal, tuberculose multissistémica

OBJECTIVES Type 2 diabetes (T2D) is considered one of the most prevalent diseases worldwide. The aim of this study was to analyse the risk of developing T2D in a higher education community of Bragança, North-Eastern Portugal. METHODS The observational, cross-sectional and prospective sample comprised 3021 individuals, aged between 18 and 64 years old, of whom 1759 were women (mean age 24.16 ± 8.80 years) and 1263 were men (mean age 23.37 ± 8.70 years). The Finnish Diabetes Risk Score (FINDRISC) questionnaire was employed to estimate the risk of developing T2D over the next 10 years. RESULTS The results indicated that approximately 37 (1%) participants in the sample exhibited a high risk of developing T2D, 117 (4%) participants exhibited a moderate risk, 660 (22%) participants exhibited a slight risk, and 2206 (73%) participants exhibited a low risk. A higher T2D risk was observed in the staff group in comparison with the other groups (p < 0.001). Furthermore, body mass index (BMI) and waist circumference (WC) were the variables that most contributed to the increased risk of developing T2D (X2 = 1034.5; p < 0.001). CONCLUSIONS In conclusion, the study reported a low T2D risk for the higher education community of Bragança in the Portuguese North-Eastern region. However, the risk of T2D was found to be higher in the staff group than in the student group. The FINDRISK questionnaire may be applied for the early diagnosis of T2D risk factors.

Coronaviruses (CoV) infect a wide variety of hosts, causing epidemics in humans, birds, and mammals over the years. Bats (order Chiroptera) are one of the natural hosts of the Coronaviridae family. They represent 40% of the total number of mammal species in the Pantanal, a biodiversity hotspot in South America. Given the recent SARS-CoV-2 pandemic, we investigated the presence of CoV in bats captured in the Brazilian Pantanal. Oral and rectal swabs collected in 2021 from 419 bats were analyzed using Pancoronavirus-nested PCR targeting the RNA-dependent RNA-polymerase (RdRp) gene. Orthocoronavirinae was detected in 16.7% (70/419) of the bats; nine samples were sequenced, confirming that Carollia perspicillata (4), Phyllostomus hastatus (2), Desmodus rotundus (1), Molossus rufus (1), and Myotis cf. nigricans (1) collected in buildings formally used by humans were infected by Alphacoronavirus genera. This is the first description of Alphacoronavirus in bats from the Pantanal. As they are natural reservoirs of CoVs, constant monitoring of bats is important to comprehend the epidemiology of emerging viruses, especially in the Pantanal biome.

Objectives: To compare the impact of the type of urinary incontinence on women's quality of life. Methods: A retrospective evaluation was conducted on the medical records of 77 incontinent women who underwent physical therapy treatment between February 2005 and October 2006. Based on the urodynamic test data, the women were classified into three groups: stress urinary incontinence (SUI), overactive bladder (OB) and mixed urinary incontinence (MUI). The subjects' history was taken, the women provided demographic data and they answered the King's Health Questionnaire, which is a specific questionnaire for assessing the quality of life among individuals with urinary incontinence. Results: Most of the patients (44%) had MUI. The patients affected by OB were significantly older than the patients in the other groups. The negative impact of incontinence on quality of life (General Health Perception domain) and lifestyle was significantly greater among the women affected by MUI than among the patients in the other groups. Conclusion: This study indicated that the negative impact of incontinence on quality of life was greater among patients with MUI. [ABSTRACT FROM AUTHOR]

Background: From conception to 6 months of age, an infant is entirely dependent for its nutrition on the mother: via the placenta and then ideally via exclusive breastfeeding. This period of 15 months – about 500 days – is the most important and vulnerable in a child's life: it must be protected through policies supporting maternal nutrition and health. Those addressing nutritional status are discussed here. Objective and design: This paper aims to summarize research on policies and programs to protect women's nutrition in order to improve birth outcomes in low- and middle-income countries, based on studies of efficacy from the literature, and on effectiveness, globally and in selected countries involving in-depth data collection in communities in Ethiopia, India and Northern Nigeria. Results of this research have been published in the academic literature (more than 30 papers). The conclusions now need to be advocated to policy-makers. Results: The priority problems addressed are: intrauterine growth restriction (IUGR), women's anemia, thinness, and stunting. The priority interventions that need to be widely expanded for women before and during pregnancy, are: supplementation with iron–folic acid or multiple micronutrients; expanding coverage of iodine fortification of salt particularly to remote areas and the poorest populations; targeted provision of balanced protein energy supplements when significant resources are available; reducing teenage pregnancies; increasing interpregnancy intervals through family planning programs; and building on conditional cash transfer programs, both to provide resources and as a platform for public education. All these have known efficacy but are of inadequate coverage and resourcing. The next steps are to overcome barriers to wide implementation, without which targets for maternal and child health and nutrition (e.g. by WHO) are unlikely to be met, especially in the poorest countries. Conclusions: This agenda requires policy decisions both at Ministry and donor levels, and throughout the administrative system. Evidence-based interventions are established as a basis for these decisions, there are clear advocacy messages, and there are no scientific reasons for delay.

Background and Objectives: Little is known about the views of service providers currently working in telehealth early medical abortion (EMA) provision in Victoria, Australia. This study aims to contextualise the enablers and barriers to telehealth EMA provision, providing insight for healthcare policy and practice to improve the accessibility of this service., Method: This was a qualitative descriptive study involving semi-structured interviews with 14 Victorian stakeholders with expertise and knowledge on telehealth EMA provision. Data were analysed using conventional content analysis., Results: This study presents perceived enablers and barriers across four different contexts of the Victorian abortion system: (1) perceived patient context; (2) perceived provider context; (3) health organisation-system context; and (4) sociopolitical context. The COVID-19 pandemic's disruption of healthcare services led to greater patient and provider acceptance of telehealth EMA. However, barriers within the patient context included the inability to ensure safety and confidentiality, digital access and literacy issues, language barriers, and the importance of trusting provider-patient relationships. Providers encountered challenges in delivering holistic care via telehealth, including time and workload issues and working with interpreters. Shortcomings within the organisational context encompassed structural barriers for culturally and linguistically diverse population groups, the absence of standard telehealth guidelines and varying interpretations of telehealth. Although temporary Medicare item number changes improved access, they presented financial challenges for mixed and private billing practices., Discussion: The application of these findings by relevant health services and policymakers has the potential to improve the quality of, and increase accessibility to, telehealth EMA, better meeting the needs of individuals seeking this service.

Seabirds interact with fishing vessels to consume fishing discards and baits, sometimes resulting in incidental capture (bycatch) and the death of the bird, which has clear conservation implications. To understand seabird-fishery interactions at large spatiotemporal scales, researchers are increasing their use of simultaneous seabird and fishing vessel tracking. However, vessel tracking data can contain gaps due to technical problems, illicit manipulation, or lack of adoption of tracking monitoring systems. These gaps might lead to underestimating the fishing effort and bycatch rates and jeopardize the effectiveness of marine conservation. We deployed bird-borne radar detector tags capable of recording radar signals from vessels. We placed tags on 88 shearwaters (Calonectris diomedea, Calonectris borealis, and Calonectris edwardsii) that forage in the northwestern Mediterranean Sea and the Canary Current Large Marine Ecosystem. We modeled vessel radar detections registered by the tags in relation to gridded automatic identification system (AIS) vessel tracking data to examine the spatiotemporal dynamics of seabird-vessel interactions and identify unreported fishing activity areas. Our models showed a moderate fit (area under the curve >0.7) to vessel tracking data, indicating a strong association of shearwaters to fishing vessels in major fishing grounds. Although in high-marine-traffic regions, radar detections were also driven by nonfishing vessels. The tags registered the presence of potential unregulated and unreported fishing vessels in West African waters, where merchant shipping is unusual but fishing activity is intense. Overall, bird-borne radar detectors showed areas and periods when the association of seabirds with legal and illegal fishing vessels was high. Bird-borne radar detectors could improve the focus of conservation efforts., (© 2024 The Authors. Conservation Biology published by Wiley Periodicals LLC on behalf of Society for Conservation Biology.)

Abstract: Hypermetabolic reprogramming triggered by thermal injury causes substantial morbidity and mortality. Despite the therapeutic potential of targeting this response, the underlying mechanisms remain poorly understood. Interestingly, protein S-acylation is a reversible posttranslational modification induced by metabolic alterations via DHHC acyltransferases. While this modification aids in the regulation of cellular functions, deregulated S-acylation contributes to various diseases by altering protein structure, stability, and localization. However, whether and how S-acylation may impact morbidity and mortality during postburn hypermetabolism is unknown. In this study, we discovered that alterations in the acyl proteome play a key role in mediating adverse outcomes that occur after burn injury. Using a murine model, we show that burn injury induces profound changes in the expression of various DHHC isoforms in metabolic organs central to regulating postburn hypermetabolism, the adipose tissue, and liver. This was accompanied by increased levels of S-acylated proteins in several pathways involved in mediating the adverse hypermetabolic response, including ER stress, lipolysis, and browning. In fact, similar results were also observed in adipose tissue from severely burned patients, as reflected by increased S-acylation of ERK1/2, eIF2a, ATGL, FGF21, and UCP1 relative to nonburn controls. Importantly, pharmacologically targeting this posttranslational modification using a nonselective DHHC inhibitor effectively attenuated burn-induced ER stress, lipolysis, and browning induction in an ex vivo explant model. Together, these findings suggest that S-acylation may facilitate the protein activation profile that drives burn-induced hypermetabolism and that targeting it could potentially be an effective strategy to restore metabolic function and improve outcomes after injury., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by the Shock Society.)

Prior animal and cell studies have demonstrated a direct role of high-density lipoprotein (HDL) and apolipoprotein A-I (ApoA-I) in enhancing skeletal muscle mitochondrial function and exercise capacity. However, the relevance of these animal and cell investigations in humans remains unknown. Therefore, a cross-sectional study was conducted in 48 adults (67% female, 8% Black participants, age 39 ± 15.4 yr old) to characterize the associations between HDL measures, ApoA-I, and muscle mitochondrial function. Forearm muscle oxygen recovery time (tau) from postexercise recovery kinetics was used to assess skeletal muscle mitochondrial function. Lipoprotein measures were assessed by nuclear magnetic resonance. HDL efflux capacity was assessed using J774 macrophages, radiolabeled cholesterol, and apolipoprotein B-depleted plasma both with and without added cyclic adenosine monophosphate. In univariate analyses, faster skeletal muscle oxygen recovery time (lower tau) was significantly associated with higher levels of HDL cholesterol (HDL-C), ApoA-I, and larger mean HDL size, but not HDL cholesterol efflux capacity. Slower recovery time (higher tau) was positively associated with body mass index (BMI) and fasting plasma glucose (FPG). In multivariable linear regression analyses, higher levels of HDL-C and ApoA-I, as well as larger HDL size, were independently associated with faster skeletal muscle oxygen recovery times that persisted after adjusting for BMI and FPG (all P < 0.05). In conclusion, higher levels of HDL-C, ApoA-I, and larger mean HDL size were independently associated with enhanced skeletal muscle mitochondrial function in healthy humans. NEW & NOTEWORTHY Our study provides the first direct evidence supporting the beneficial role of HDL-C and ApoA-I on enhanced skeletal muscle mitochondrial function in healthy young to middle-aged humans without cardiometabolic disease.

Background: The ultimate goal of advanced procedures in prosthetic dentistry is to construct a prosthesis based on the accurate reproduction of condylar guidance., Aim: To compare the sagittal condylar inclination obtained using the cone-beam computed tomography (CBCT), panoramic image, and two articulator systems., Settings and Design: A cross-sectional study was carried out in 20 dentate patients in the age group of 20-40 years., Materials and Methods: Sagittal condylar guidance angles (SCGAs) were measured on two semi-adjustable articulators (Hanau Wide Vue and Denar Mark 320) using protrusive interocclusal record. SCGAs were also measured on the CBCT scans (CBCT reconstructed panoramic image and CBCT sagittal cross section) and the panoramic images obtained from the patients. The angles were determined on the radiographs by joining two lines: Frankfort's horizontal plane and the other plane were drawn by connecting the superior-most point on the glenoid fossa and the inferior-most point on the articular eminence. All the measurements were done twice by two operators independently., Statistical Analysis Used: The data were analyzed using the paired t -test and Pearson's correlation coefficient with a P ≤ 0.05., Results: There was no significant difference between the right and the left side in any of the groups ( P ≥ 0.05). In addition, there was no significant difference between the clinical methods ( P ≥ 0.05). However, there was a significant difference between the clinical and the radiographic methods ( P ≤ 0.05). Furthermore, there was a strong correlation between the clinical and radiographic methods with Pearson's Correlation coefficient above 0.67., Conclusion: There is a strong correlation between the clinical and radiographic methods. Thus, CBCT and OPG can be used an adjunct to clinical methods to record sagittal condylar guidance., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Contemporary Clinical Dentistry.)

Considerable advances in the diagnosis and treatment of cancer have made a huge impact on morbidity and mortality from neoplastic diseases. However, cancer remains the leading cause of death across the world. This is a retrospective study carried out at a tertiary cancer care centre (Kidwai Memorial Institute of Oncology, Bangalore) in South India. Case records of all cancer patients who died while receiving inpatient treatment between January 2022 and December 2022 under the Department of Medical Oncology were reviewed and studied. There was a total of 240 deaths. Out of these, the majority of deaths 147 (61.25%) were patients with haematological malignancies while the remaining 93 (38.75%) were patients with solid tumours. In patients with solid tumours, the majority 49 (52.7%) were in the age group of 40 to 60 years while only 18 (19.35%) patients were less than 40 years. The majority of patients were male sex i.e. 55(59.1%) and undergoing treatment with palliative intent 81 (87%). The most common organ was the lung in 21 patients (22.6%) followed by the breast while the most common system involved was the gastrointestinal tract in 28 (30.1%) patients. The most frequent cause of death was progressive disease in 72 (77.4%) while sepsis (11 patients; 11.8%) was the second most frequent cause of death in solid tumours. In haematological malignancies, also a significant number of 57 (38.8%) patients were in the age group of 40 to 60 years. Fifty-two (35.3%) patients were in the age group of 22 to 40 years. The majority were male sex (79 patients; 53.7%). About the phase of treatment, the majority of deaths 45 (30.6%) were during induction and under evaluation. Those with relapse/refractory disease were 38 (25.9%). A substantial number of patients had acute myeloid leukaemia 47 (32%) and five (3.4%) deaths were acute promyelocytic leukaemia patients. Twenty-three patients (15.6%) had acute lymphoblastic leukaemia. The most common cause of death was sepsis in 76 patients (51.7%) while intracranial bleeding was in 34 patients (23.1%). In some patients, there were multiple causes leading to death. Mortality audits are important to evaluate the services being provided at any centre. One can appreciate the lacunae in handling a particular disease or flaws in a treatment protocol or the staff delivering the treatment. Sepsis is the leading cause of death in patients with haematological malignancy; even in solid malignancy sepsis accounts for a substantial proportion of deaths and should be handled aggressively to save lives., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Choudhary et al.)

Purpose Triple-negative breast cancer (TNBC) has a poor outcome compared to other subtypes. Immune checkpoint inhibitors (ICIs) have changed the treatment paradigm in metastatic diseases as well as in neoadjuvant setting. The response to these agents is affected by programmed death ligand 1 (PDL1) receptor expression which are reported objectively as a score. PDL1 is a prognostic marker also. Here, we present clinicopathological characteristics of metastatic TNBCs, report the proportion of PDL1 expression and its association with clinicopathological factors as well as survival. Methods This is a prospective study carried out at a tertiary cancer care centre in South India. Case records of all breast cancer patients treated in two years between August 2021 and July 2023 were reviewed, patients with metastatic TNBC were selected. Patient's characteristics, histological features, molecular profile, and treatment were analyzed. PDL1 testing was carried out on pretreatment tumor tissue sections with immunohistochemistry (IHC) (Dako 22C3). PDL1 staining was interpreted as negative or positive based on combined positive score (CPS), with an expression less than 10 considered negative. Results A total of 118 patients were analyzed. With a median age of 46 years (36-65 years), 52.5% (62/118) were premenopausal. Family history of Ca Breast was seen in 22% (26/118) patients. A majority of patients had left-sided tumor 55.9% (66/118). Visceral metastasis was more common 96.6% (82/118) than skeletal. Radical intent of treatment was adopted in 10% as patients had oligometastatic disease at presentation. As front-line treatment, anthracycline-based chemotherapy was administered to the majority 54.2% (64/118). The PDL1 expression with CPS more or equal to 10 was seen in 32.2% (38/118) patients. Survival was associated with menopausal status (p value=0.000) and family history (p value=0.028) but not with PDL1 nor sidedness in our study. Estimated survival at 12 months in PDL1 negative case is 10 ± 0.29 months, while in PDL1 positive case it is slightly more at 10 ± 0.75 months, but difference was not found to be statistically significant (p value=0.15). Conclusion TNBCs are highly aggressive subtype with limited treatment options and poorer outcomes. Our study shows PDL1 expression in 31.66% of the cases similar to other literature from India. Survival is associated with menopausal status and family history. No association was found between survival and PDL1 as well sidedness in our study., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Babu et al.)

Background: Engagement with general practice is a requirement of Australia's Primary Health Networks (PHNs). We propose a model for engagement that draws on principles of stakeholder and clinician engagement, tailored to meet the needs of PHNs and general practitioners (GPs)., Methods: A comprehensive literature review was undertaken to identify components, challenges, and approaches to optimizing clinician engagement. Interviews with GPs (n = 18), other practice staff (n = 12), PHN staff, and other stakeholders (n = 15) across 3 PHN regions in Victoria, Australia, were used to identify perceived needs of GPs and opportunities for engagement with PHNs. Interview transcripts, notes, and contact summaries were collated and organized using QSR NVivo to support the process of coding and identification of common themes and perspectives. Information from the literature and interviews was synthesized to inform development of a model for GP engagement that could guide GP strategy and engagement activities undertaken by PHNs., Findings: PHNs engaged with GPs for accreditation, quality improvement, data sharing, continuing professional development, commissioning, and population health initiatives, among others. GPs were motivated to engage with PHNs, however, the roles of PHNs and benefits of engagement were not always clear. A model to support PHN engagement with general practice was developed comprising: (1) Organizational values for engagement; (2) Needs of GPs; (3) Areas of engagement; (4) Stages of engagement; (5) Communication planning; and (6) Monitoring and Evaluation., Conclusion: The proposed model represents contemporary understanding in clinician engagement, drawing upon concepts from community and stakeholder engagement, and extending established models for engagement into the setting of general practice., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Body condition in pelagic seabirds impacts key fitness-related traits such as reproductive performance and breeding frequency. Regulation of body condition can be especially important for species with long incubation periods and long individual incubation shifts between foraging trips. Here, we show that body condition of adult Red-billed Tropicbirds ( Phaethon aethereus ) at St Helena Island, South Atlantic Ocean, exhibited considerable variation between years (2013-2017) and between different stages of the breeding cycle. Females took the first incubation shift following egg laying, after which males and females alternated incubation shifts of varying length, ranging from <1 to 12 days. Body condition declined in both sexes during an incubation shift by an average of 22 g (2.83% of starting mass) per day and over the incubation period; mass loss was significantly greater during longer incubation shifts, later within a shift and later in the total incubation period. There was also significant differences in incubation behaviour and body condition between years; in 2015, coinciding with a moderate coastal warming event along the Angolan-Namibian coastlines, adults on average undertook longer incubation shifts than in other years and had lower body condition. This suggests that substantial between-year prey fluctuations in the Angola Benguela upwelling system may influence prey availability, in turn affecting incubation behaviour and regulation of body condition. Adults rearing chicks showed a significant reduction in body condition when chicks showed the fastest rate of growth. Chick growth rates during 2017 from two localities in the Atlantic Ocean: an oceanic (St Helena) versus neritic (Cabo Verde) population were similar, but chicks from St Helena were overall heavier and larger at fledging. Results from this multi-year study highlight that flexibility and adaptability in body condition regulation will be important for populations of threatened species to optimise resources as global climate change increasingly influences prey availability., (© 2023 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Background: To investigate and compare the effect of four commercially used dental cement at 24 hours, 48 hours,72 hours (h) and 6 days on the cellular response of human gingival fibroblast (HGF)., Methods: 3 cement pellet samples were made for each 4-test cement (n=12). The cement used for this study were zinc phosphate (ZP), zinc oxide non-eugenol (ZOE), RelyX U200 (RU200), and glass ionomer cement (GIC). The cytotoxicity of peri-implant tissues was investigated using one commercial cell line. All processing was done following International Organization for Standardization (ISO) methods 10993-5 and 10993-12 (MTT assay Test). Cell cultures without dental cement were considered as control. Standard laboratory procedures were followed to permit cell growth and confluence over 48 hrs after sub-cultivation. Before being subjected to analysis, the cells were kept in direct contact with the cement samples for the suggested time period. To validate the results the specimens were tested three times each. Cell death and inhibition of cell growth were measured quantitatively. Results were analyzed using 1-way ANOVA (a=0.05) followed by Tukey B post hoc test., Results: The study showed the dental cement test material was cytotoxic. ZOE, ZP, GIC, and RU200 were cytotoxic in decreasing order, respectively, significantly reducing cell viability after exposure to HGF (p <0.001)., Conclusions: Within the limitations of this in-vitro cellular study, results indicated that HGF were vulnerable to the test the dental cement. The highest cytotoxicity was observed in ZOE, followed by ZP, GIC, and RU200., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Bajantri P et al.)

High-density lipoproteins (HDLs) are promising targets for predicting and treating atherosclerotic cardiovascular disease (ASCVD), as they mediate removal of excess cholesterol from lipid-laden macrophages that accumulate in the vasculature. This functional property of HDLs, termed cholesterol efflux capacity (CEC), is inversely associated with ASCVD. HDLs are compositionally diverse, associating with >250 different proteins, but their relative contribution to CEC remains poorly understood. Our goal was to identify and define key HDL-associated proteins that modulate CEC in humans. The proteomic signature of plasma HDL was quantified in 36 individuals in the multi-ethnic population-based Dallas Heart Study (DHS) cohort that exhibited persistent extremely high (>=90th%) or extremely low CEC (<=10th%) over 15 years. Levels of apolipoprotein (Apo)A-I associated ApoC-II, ApoC-III, and ApoA-IV were differentially correlated with CEC in high (r = 0.49, 0.41, and -0.21 respectively) and low (r = -0.46, -0.41, and 0.66 respectively) CEC groups (p for heterogeneity (pHet) = 0.03, 0.04, and 0.003 respectively). Further, we observed that levels of ApoA-I with ApoC-III, complement C3 (CO3), ApoE, and plasminogen (PLMG) were inversely associated with CEC in individuals within the low CEC group (r = -0.11 to -0.25 for subspecies with these proteins vs. r = 0.58 to 0.65 for subspecies lacking these proteins; p < 0.05 for heterogeneity). These findings suggest that enrichment of specific proteins on HDLs and, thus, different subspecies of HDLs, differentially modulate the removal of cholesterol from the vasculature.

Introduction: Reproductive coercion (RC) describes behaviours that interfere with an individual's reproductive autonomy and decision-making. RC can be a form of intimate partner violence and overlaps with other forms of gender-based violence, such as sexual violence. Health settings are well placed to identify and intervene to support patients experiencing RC, however, the lack of conceptual clarity on RC means that health providers are not easily able to identify those at risk of experiencing RC. To facilitate appropriate identification and development of interventions, there is a need to understand the risk factors related to experiencing RC and associated health consequences., Aim: To assess the current scope of evidence in relation to risk factors and health consequences of experiencing RC., Methods and Analysis: Eligible articles for inclusion in the scoping review will be original peer-reviewed literature that describe risk factors and health consequences of any type of RC. Studies on humans published in English since 2010 will be included. The proposed scoping review will be conducted in accordance with the JBI Methodology. This protocol is reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. Five electronic databases, OVID Medline, CINAHL, Scopus, PsychINFO and Embase, will be searched for relevant literature from 1 January 2010 to 23 January 2023. Two reviewers will individually screen and review articles for eligibility, and conflicts will be resolved by a third reviewer. Data will be charted and reported using a tool developed for the purpose of this review., Ethics and Dissemination: Findings will be disseminated in publications and presentations to relevant stakeholders. Ethical approval is not required as data from publicly available literature sources will be used. Available evidence will be mapped across the breadth of eligible studies to identify associated risk factors and health consequences of RC., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)